Sheet1WILLIAM BEE RIRIE HOSPITALLIST OF CHARGESAS OF: NOVEMBER
7, 2018PRICINGCHG#DESCRIPTIONINPATIENTOUTPATIENTERCLINICOTHER
11111OBSERVATION HOURLY CHARGE86- 0- 0- 0- 0 20610CORTISONE- 0- 0-
0- 0- 0 23650CL TX SHOULDER DISLOC W/MAN650- 0- 0- 0- 0
42231ACROMIOPLASTY OR ACROMI- 0- 0- 0- 0- 0 42415LAT W/DISSECTION
PRESERVATION FACIAL NER- 0- 0- 03,240- 0 52648LASER TURP5,028- 0-
03,180- 0 90701INTERFERON BETA 10 MCG PER INJ10- 0- 0204- 0
99001BAD DEBT WRITE-OFF- 0- 0- 0- 0- 0 99002SMALL BALANCE
ADJUSTMENT- 0- 0- 0- 0- 0 99003BALANCE TRANSFER- 0- 0- 0- 0- 0
99004BAD DEBT RECOVERY- 0- 0- 0- 0- 0 99005RETURNED CHECK CHARGE30-
0- 0- 0- 0 99006PATIENT REFUND- 0- 0- 0- 0- 0 99007PRIOR BAD DEBT-
0- 0- 0- 0- 0 99008EMPLOYEE PHYSICAL DISC- 0- 0- 0- 0- 0
99009BANKRUPTCY- 0- 0- 0- 0- 0 99010CONTRACT PHYSICAL ADJ- 0- 0- 0-
0- 0 99011PR AR DEDUCTION- 0- 0- 0- 0- 0 99012SLIDING FEE DISCOUNT-
0- 0- 0- 0- 0 99013PROMPT PAY DISCOUNT- 0- 0- 0- 0- 0
99014UNCOMPENSATED CARE- 0- 0- 0- 0- 0 99015SECONDARY PREFERRED- 0-
0- 0- 0- 0 99016INDIGENT DISCOUNT- 0- 0- 0- 0- 0 99017CHARITY CARE
DISCOUNT- 0- 0- 0- 0- 0 99018RISK MANAGEMENT- 0- 0- 0- 0- 0
99019CUSTOMER SERVICE- 0- 0- 0- 0- 0 99020STALEDATE/ULTIMELY- 0- 0-
0- 0- 0 99021HEALTH FAIR- 0- 0- 0- 0- 0 99022CHARGE ERROR- 0- 0- 0-
0- 0 99023INSURANCE REFUND- 0- 0- 0- 0- 0 99024PATIENT INTEREST- 0-
0- 0- 0- 0 99025PATIENT FINANCE CHARGE QUE- 0- 0- 0- 0- 0
99026DOWNWINDERS XRAY DISCOUNT- 0- 0- 0- 0- 0 99027BREAST CANCER
AWARENESS DISCOUNT- 0- 0- 0- 0- 0 99028MEDICARE ALLOWANCE- 0- 0- 0-
0- 0 99029MEDICARE NON COVERED- 0- 0- 0- 0- 0 99030MEDICAID
ADJUSTMENT- 0- 0- 0- 0- 0 99031PPO/HMO ADJUSTMENT- 0- 0- 0- 0- 0
99032IHS ADJUSTMENT- 0- 0- 0- 0- 0 99033WORKMANS COMP ADJ- 0- 0- 0-
0- 0 99034VA PILOT PROGRAM ADJUSTMENT- 0- 0- 0- 0- 0 99035MEDICARE
BAD DEBTS- 0- 0- 0- 0- 0 99036PSA DISCOUNT- 0- 0- 0- 0- 0
99037MCARE RURL FLU/PNUEM NO PHYS- 0- 0- 0- 0- 0
99038ADMINISTRATIVE ADJ- 0- 0- 0- 0- 0 99039SELF PAY SPECIAL
DISCOUNT- 0- 0- 0- 0- 0 99040BEGINNING BALANCE- 0- 0- 0- 0- 0
99041SCHOOL DIST FLU SHOT- 0- 0- 0- 0- 0 99042WBRH EMP DISCOUNT- 0-
0- 0- 0- 0 99043FOUR YR BAD DEBT ADJ- 0- 0- 0- 0- 0 99044OLD CREDIT
BAL ADJ- 0- 0- 0- 0- 0 99045SLOW PAY ACCOUNT- 0- 0- 0- 0- 0
99046PERSONAL PAY NBF CK- 0- 0- 0- 0- 0 99047PERSONAL PAY NBF VI-
0- 0- 0- 0- 0 99048PERSONAL PAY NBF MC- 0- 0- 0- 0- 0 99049PERSONAL
PAY NBF MO- 0- 0- 0- 0- 0 99050LATE CHGS 30 CM1,595- 0- 0- 0- 0
212031REPAIR INTERM 2.5 CM OR LESS357- 0- 0- 0- 0 212032REPAIR
INTERM 2.6-7.5 CM595- 0- 0- 0- 0 212033REPAIR INTERM 2.5 CM OR
LESS294- 0- 0- 0- 0 212034REPAIR INTERM 7.6-12.5 CM516- 0- 0- 0- 0
212035REPAIR INTERM 12.6-20 CM576- 0- 0- 0- 0 212037REPAIR INTERM
OVER 30.0 CM691- 0- 0- 0- 0 212038REPAIR INTERM 2.6-7.5 CM294- 0-
0- 0- 0 212039REPAIR INTERM 7.6-12.5 CM294- 0- 0- 0- 0 212040REPAIR
INTERM 12.6-20 CM294- 0- 0- 0- 0 212041REPAIR INTERM 2.5 CM OR
LESS437- 0437- 0- 0 212042REPAIR INTERM 2.6-7.5 CM456- 0- 0- 0- 0
212043REPAIR INTERM 2.5 CM OR LESS294- 0- 0- 0- 0 212044REPAIR
INTERM 7.6-12.5 CM536- 0- 0- 0- 0 212046REPAIR INTERM 20.1-30.0
CM734- 0- 0- 0- 0 212048REPAIR INTERM 2.6-7.5 CM294- 0- 0- 0- 0
212049REPAIR INTERM 7.6-12.5 CM294- 0- 0- 0- 0 212050REPAIR INTERM
20.1-30.0 CM294- 0- 0- 0- 0 212051REPAIR INTERM 2.5 CM OR LESS471-
0471- 0- 0 212052REPAIR INTERM 2.6-5.0 CM477- 0- 0- 0- 0
212053REPAIR INTERM 5.1-7.5 CM595- 0595- 0- 0 212054INTND RPR
FACE/MM 7.6-12.5CM869869869- 0- 0 212058REPAIR INTERM 2.5 CM OR
LESS294- 0- 0- 0- 0 212059REPAIR INTERM 2.6-5.0 CM294- 0- 0- 0- 0
212060REPAIR INTERM 5.1-7.5 CM294- 0- 0- 0- 0 213100COMPLEX RPR
TRUNK 1.1-2.5 CM2,158- 02,158- 0- 0 213101COMPLEX RPR TRUNK 2.6-7.5
CM483- 0- 0- 0- 0 213103COMPLEX RPR TRUNK 2.6-7.5 CM2,047- 0- 0- 0-
0 213120REPAIR COMP 1.1-2.5 CM437- 0437- 0- 0 213121REPAIR COMP
2.6-7.5 CM675- 0675- 0- 0 213122REPAIR COMP EA ADDL 5 CM OR
LESS275- 0275- 0- 0 213123REPAIR COMP 1.1-2.5 CM294- 0- 0- 0- 0
213124REPAIR COMP 2.6-7.5 CM294- 0- 0- 0- 0 213125REPAIR COMP EA
ADDL 5 CM OR LESS294- 0- 0- 0- 0 213131REPAIR COMP 1.1-2.5 CM576-
0- 0- 0- 0 213132REPAIR COMP 2.6-7.5 CM971- 0971- 0- 0 213133REPAIR
WOUND LESION ADD ON387- 0387- 0- 0 213134REPAIR COMP 1.1-2.5 CM294-
0- 0- 0- 0 213135REPAIR COMP 2.6-7.5 CM441- 0- 0- 0- 0 213136REPAIR
WOUND LESION ADD-ON294- 0- 0- 0- 0 213150COMPLEX REPAIR FACE
>1390- 0- 0- 0- 0 213151REPAIR COMP EYELIDS/NOSE734- 0- 0- 0- 0
213152REPAIR COMP EYELIDS NOSE1,228- 01,228- 0- 0 213154LAC RPR CX
LNEL 1.1-2.5 CM441- 0- 0- 0- 0 213155LAC RPR CX LNEL 2.6-7.5 CM441-
0- 0- 0- 0 213156COMPLEX REPAIR FACE < 1 CM1,651- 0- 0- 0- 0
215240FULL THICKNESS GRAFT 20CM OR LESS3,046- 03,046- 0- 0
215242FULL GRAFT 20 SQ CM/887- 0887- 0- 0 220554INJ TENDON
ORIGIN/INSERTION294- 0- 0- 0- 0 220556INJ TRIGGER POINT 1/2
MUSCL294- 0- 0- 0- 0 220600DRAIN/INJ JOINT/BURSA W/O US- 0- 0811-
0- 0 220605DRAIN/INJ JOINT/BURSA W/O US840- 0840- 0- 0
220607DRAIN/INJ JOINT/BURSA W/O US88- 088- 0- 0
220610ARTHROCENTESIS MAJOR JOINT OR BURSA959- 0- 0- 0- 0
220611ASP/INJ MJR JT BURS CYST294- 0- 0- 0- 0 221315CL TX NASAL
BONE FX W/O STABILIZATION397- 0- 0- 0- 0 221316TX NOSE FX W/O
STABILIZ1,175- 0- 0- 0- 0 221337CLOSED TX SEPTAL & NOSE
FX4,336- 04,336- 0- 0 221480CL TX TEMPROMANDIBULAR DSLOC571- 0571-
0- 0 221481RESET DISLOCATED JAW294- 0- 0- 0- 0 221800TREATMENT OF
RIB FRACTURE250- 0- 0- 0- 0 221801CLO TX RIB FX UNCOMPLIC EA294- 0-
0- 0- 0 222015I&D DEEP ABSCESS SPINE2,492- 0- 0- 0- 0
222016I&D DEEP ABSCESS SPINE294- 0- 0- 0- 0 223605CL TX
PROXIMAL HUMERAL FX991- 0991- 0- 0 223606TX PROX HUM FX WMANIP588-
0- 0- 0- 0 223650CL TX SHOULDER DISLOC W/MAN650- 0- 0- 0- 0
223651TX SHLDR DISL WOANES294- 0- 0- 0- 0 223655CL TX SHLDR DISLOC
W AN931- 0931- 0- 0 223656CLO TX SHLDR DISL W ANES1,175- 0- 0- 0- 0
223675CL TX SHOULDER DISLOCATION803- 0- 0- 0- 0 223676CLO TX SHLDR
DISLWSUR NECK FX294- 0- 0- 0- 0 223931I & D UPPER ARM, ELBOW;
BURSA654- 0- 0- 0- 0 223932I&D UP ARM ELBOW BURSA588- 0- 0- 0-
0 224065BX SOFT TISSUE UPPER ARM319- 0- 0- 0- 0 224067BX SOF TISS
ARM ELBOW SUPRFIC1,175- 0- 0- 0- 0 224600TREAT ELBOW
DISLOCATION851- 0851- 0- 0 224605TREAT ELBOW
DISLOCATION2,7892,7892,789- 0- 0 224620TREAT ELBOW FRACTURE1,924-
01,924- 0- 0 224640CL TX RADIAL HEAD SUBLU CHILD516- 0- 0- 0- 0
224641TX RADI HEAD SUBLUX CHILD294- 0- 0- 0- 0 225505TREAT FX. OF
RADIUS1,368- 01,368- 0- 0 225506CLOSED TX RAD SHAFT FX W/MANIP441-
0- 0- 0- 0 225561TREAT FRACTURE RADIUS1,444- 0- 0- 0- 0 225565TREAT
FRACTURE RADIUS1,161- 0- 0- 0- 0 225605CL TX DISTAL RADIAL FX892-
0- 0- 0- 0 225610CLOSED TX DIST TX W/MANIP441- 0- 0- 0- 0
226010DRAIN FINGER ABSCESS SIMPLE199- 0- 0- 0- 0 226011DRAINAGE OF
FINGER ABSCESS773- 0- 0- 0- 0 226012DRAIN FINGER ABSCESS SIMPLE294-
0- 0- 0- 0 226013DRAIN FINGER ABSCESS CX588- 0- 0- 0- 0
226418REPAIR EXTENSION TENDON FINGER991- 0- 0- 0- 0 226419RPR XTNSR
FING W/O GRAF1,175- 0- 0- 0- 0 226605CL TX METACARPAL FX555- 0- 0-
0- 0 226606CLOSED TX MC FX W/MANIP294- 0- 0- 0- 0 226700TREAT
KNUCKLE DISLOCATION421- 0421- 0- 0 226701CLOSED TX MP DISLOC W/O
ANES294- 0- 0- 0- 0 226720CL TX PHALANGEAL SHAFT FX338- 0338- 0- 0
226721XLO TX PHALANG FX W/O MANIP294- 0- 0- 0- 0 226725TREAT FINGER
FRACTURE EACH429- 0- 0- 0- 0 226726TREAT FINGER FRACTURE EACH588-
0- 0- 0- 0 226755CL TX DISTAL PHALANGEAL FX239- 0239- 0- 0
226757CLOSED TX DIST PHLANG FX W/MANIP294- 0- 0- 0- 0 226770CL TX
INTERPHALANGEAL JOINT239- 0- 0- 0- 0 226771CLOSED TX IP JT DISL W/O
ANES294- 0- 0- 0- 0 226952AMP FINGER OR THUMB1,650- 01,650- 0- 0
226953AMPU FINGR/THUMB W/LOCAL FLAP1,171- 0- 0- 0- 0 227252TREAT
HIP DISLOCATION2,7502,7502,750- 0- 0 227257TREAT HIP
DISLOCATION2,360- 02,360- 0- 0 227264TREAT HIP DISLOCATION963-
0963- 0- 0 227266TREAT HIP DISLOCATION3,741- 0- 0- 0- 0 227301DRAIN
THIGH/KNEE LESION6,709- 0- 0- 0- 0 227551CLO TX KNEE DISL
W/ANES4,363- 0- 0- 0- 0 227552CL TX KNEE DISLOCATION W/ ANES753- 0-
0- 0- 0 227560CL TX PATELLAR DISLOCATION516- 0516- 0- 0 227561CLO
TX PATELLAR DISL WO ANES800800- 0- 0- 0 227562TREAT KNEECAP
DISLOCATION1,428- 01,428- 0- 0 227752TREATMENT OF A TIBIA
FRACTURE1,275- 0- 0- 0- 0 227753TREATMENT OF A TIBIA FRACTURE3,902-
0- 0- 0- 0 227789TREATMENT OF ANKLE FRACTURE1,195- 01,195- 0- 0
227810TREATMENT OF ANKLE FRACTURE1,2751,275- 0- 0- 0
227818TREATMENT OF ANKLE FRACTURE1,151- 01,151- 0- 0 227819TX
TRIMALLE ANK FX W/MANIP441- 0- 0- 0- 0 227842TREATMENT OF ANKLE
LOCATION566- 0566- 0- 0 227843CLO TX ANKL DISL W ANES1,175- 0- 0-
0- 0 228190REMOVE FB FOOT SUBQ338- 0- 0- 0- 0 228191REMOV FB FOOT
SUBQ588- 0- 0- 0- 0 228192REM FB FOOT DEEP713- 0713- 0- 0
228194REMOV FB FOOT DEEP1,175- 0- 0- 0- 0 228515CL TX FX PHALANX OR
PHALANGES259- 0- 0- 0- 0 228516TX FX OTH TOE W/MANIP294- 0- 0- 0- 0
228630TREAT TOE DISLACATION620- 0620- 0- 0 228660CL TX
INTERPHALANGEAL DISLOC319319- 0- 0- 0 228661TX IP JT DISL WO
ANES294- 0- 0- 0- 0 229075APPLICATION SHORT ARM CAST161- 0- 0- 0- 0
229076APPLY SHORT ARM CAST294- 0- 0- 0- 0 229105APP LONG ARM
SPLINT121- 0- 0- 0- 0 229106APPLY LONG ARM SPLINT294- 0- 0- 0- 0
229125APPLICATION SHORT ARM SPLINT100- 0- 0- 0- 0 229126APP SHORT
ARM SPLINT DYNAMIC330- 0- 0- 0- 0 229127APPLY SHORT AMR SPLINT
STATIC294- 0- 0- 0- 0 229128APPLY SHORT ARM SPLINT DYNAM294- 0- 0-
0- 0 229130APPLICATION FINGER SPLINT100- 0- 0- 0- 0
229131APPLICATION FINGER SPLINT/DYNAMIC259- 0259- 0- 0 229132APPLY
FINGER SPLINT STATIC294- 0- 0- 0- 0 229133APPLY FINGER SPLINT
DYNAMIC294- 0- 0- 0- 0 229405APP SHORT LEG CAST161- 0- 0- 0- 0
229406APPLY SHORT LEG CAST294- 0- 0- 0- 0 229505APP LONG LEG
SPLINT140140- 0- 0- 0 229506APPLY LONG LEG SPLINT294- 0- 0- 0- 0
229515APP SHORT LEG SPLINT121- 0- 0- 0- 0 229516APPLY SHORT LEG
SPLINT294- 0- 0- 0- 0 229700REMOVAL/REVISION OF CAST313- 0313- 0- 0
230300FB REMOVAL INTRANASAL259- 0- 0- 0- 0 230301REMOVE NASAL
FOREIGN BODY294- 0- 0- 0- 0 230901CONTROL NASAL HEMMORRAGE461- 0-
0- 0- 0 230902CONTROL EPISTAX ANT SIMP294- 0- 0- 0- 0 230903CONTROL
OF NOSEBLEED269- 0- 0- 0- 0 230904CONTROL OF NOSEBLEED574- 0- 0- 0-
0 230905CONTROL NASAL HEMORRHAGE, POST537- 0537- 0- 0 230907CONTROL
NAS HEMOR POST INIT294- 0- 0- 0- 0 231500INTUBATION ENDORACHEAL
EMERGENCY PROC267- 0- 0- 0- 0 231501INTUBATION, ENDOCRACHEAL ER
PROCEDURE588- 0- 0- 0- 0 232422THORACENTESIS W/ INSERTION TUBE397-
0- 0- 0- 0 232551TUBE THORACOSTOMY W/WATER SEAL595- 0- 0- 0- 0
232554ASPIRATE PLEURA W/O IMAGING1,612- 0- 0- 0- 0
232555THORANCENTESIS W/TUBE INSERT293- 0- 0- 0- 0 232558TUBE
THORACOSTOMY W/WATERSEAL588- 0- 0- 0- 0 232559THORACNTSIS NDL CATH
ASP588- 0- 0- 0- 0 233010PERICARDIOCENTESIS INITIAL- 0- 0437- 0- 0
233012PERICARDIOCENTESIS W/TUBE INSERT1,976- 01,976- 0- 0 236000IV
ACCESS321- 0- 0- 0- 0 236001INTRO NEEDL INTRACATH VEIN294- 0- 0- 0-
0 236430BLOOD TRANFUSION PER DAY958- 0- 0- 0- 0 236556INSERT NON
TUNNEL CV CATH708- 0708- 0- 0 236559INSERT NON-TUNNEL CV
CATH>5588- 0- 0- 0- 0 236567INSERT PICC CATH2,650- 02,650- 0- 0
236569INSERT PICC CATH2,650- 0- 0- 0- 0 236593DECLOT VASCULAR
DEVICE FACILITY673- 0- 0- 0- 0 236594DECLOT VASCULAR DEVICE111- 0-
0- 0- 0 236680PLCEMENT NEEDLE INTRAOSSEOUS INF.220- 0220- 0- 0
236681NEEDLE PLACEMENT INTRAOSSEOUS INFUSH294- 0- 0- 0- 0
238120LAPAROSCOPY SPLENECTOMY17,24117,241- 0- 0- 0 241100BIOPSY OF
TONGUE2,7752,7752,775- 0- 0 241113EXC OF TONGUE LESION6,194- 0- 0-
0- 0 241250REPAIR TONGUE LACERATION618- 0618- 0- 0 241251REPAIR LAC
2.5CM < TONGUE397- 0- 0- 0- 0 241253REPAIR TONGUE LACERATION294-
0- 0- 0- 0 241800DRAINAGE OF ABSCESS239- 0- 0- 0- 0 241801DRAIN GUM
ABSCESS/CYST294- 0- 0- 0- 0 242000DRAINAGE MOUTH ROOF LESION801-
0801- 0- 0 242330REMOVAL OF SALIVARY STONE5,724- 05,724- 0- 0
242700I & D ABSCESS PERITONSILLAR338- 0338- 0- 0 242701I&D
ABSCESS PERITONSILLAR294- 0- 0- 0- 0 243235EGD DIAGNOSTIC BRUSH
WASH777777- 0- 0- 0 243760CHANGE GASTROSTOMY TUBE233- 0- 0- 0- 0
243762CHANGE GASTROSTOMY TUBE143- 0- 0- 0- 0 245300PROCTOSCOPY140-
0- 0- 0- 0 245301PROCTOSIGMOIDOSCOPY DX588- 0- 0- 0- 0
246040INCISION OF RECTAL ABSCESS547- 0- 0- 0- 0 246041INCISION OF
RECTAL ABSCESS1,175- 0- 0- 0- 0 246050I & D PERIANAL ABSCESS
SUPERFICAIL183- 0- 0- 0- 0 246051I & D PERIANAL ABSCESS2,604-
0- 0- 0- 0 246083INCISE EXTERNAL HEMORRHOID687- 0687- 0- 0
246600ANOSCOPY & DX W/ OR W/O140- 0- 0- 0- 0 246601ANOSCOPY
DX294- 0- 0- 0- 0 247525CHANGE BILE DUCT CATHETER572- 0- 0- 0- 0
247526CHANGE BILE DUCT CATHETER2,752- 0- 0- 0- 0 247563LAPARO
CHOLECYSTECTOMY/GRAPH12,163- 012,163- 0- 0 249082ABD PARACENTESIS
FACILITY1,175- 0- 0- 0- 0 249083ABD PARACENTESIS
W/IMAGING2,2042,204- 0- 0- 0 249085ABD PARACENTESIS240- 0- 0- 0- 0
249086ABD PARACENTESIS275- 0- 0- 0- 0 249402REMOVE FOREIGN BODY
ADBOMEN2,678- 0- 0- 0- 0 249403REMOVE FOREIGN BODY ADBOMEN5,261- 0-
0- 0- 0 249998TRANEXAMIC ACID IV SOLN 100MG/ML5757575757 250486SS
3.5MM CORTEX SELF TAP 18MM248- 0- 0- 0- 0 250705LINVATEC RECIP SAW
LOANER FEE1,073- 0- 0- 0- 0 251102DRAIN BL W/CATH INSERTION5,454-
05,454- 0- 0 251702INSERT TEMP URINARY CA218- 0- 0- 0- 0
251703INSERT TEMP CATH CMPLX473- 0- 0- 0- 0 251704INSERT TEMP
BLADDER CATH SMPL294- 0- 0- 0- 0 251706INSERT TEMP CATH CMPLX294-
0- 0- 0- 0 254162LYSIS PENIL CIRCUMIC LESION740740740- 0- 0
254220TREATMENT OF PENIS LESION322- 0- 0- 0- 0 254221TREATMENT OF
PENIS LESION827- 0- 0- 0- 0 254700DRAINAGE OF SCROTUM5,374- 05,374-
0- 0 255000DRAINAGE OF HYDROCELE1,175- 0- 0- 0- 0 255001DRAINAGE OF
HYDROCELE55- 0- 0- 0- 0 256405I&D VULVA PERINEAL ABSC516- 0- 0-
0- 0 256406I&D VULVA PERINEAL ABSCESS294- 0- 0- 0- 0
256420I&D BARTHOLINS GLAND ABSCESS259- 0- 0- 0- 0 256421I&D
BARTHOLIN CLAND ABSCESS294- 0- 0- 0- 0 257672DRILL BIT 5.3957- 0-
0- 0- 0 258301REMOVAL OF IUD588- 0- 0- 0- 0 258302REMOVAL OF IUD90-
0- 0- 0- 0 259409VAGINAL DELIVERY ONLY2,077- 0- 0- 0- 0
259411VAGINAL DELIVERY ONLY1,175- 0- 0- 0- 0 259896UNLISTED
MATERNITY CARE DELIVERY294- 0- 0- 0- 0 259899UNLISTED MATERNITY
PROCEDURE832- 0- 0- 0- 0 262270SPINAL PUNCTURE LUMBAR DX397- 0- 0-
0- 0 262271SPINAL PUNCTURE-LUMBAR-DX441- 0- 0- 0- 0 262272DRAIN
CEREBRO SPINAL FLUID1,695- 01,695- 0- 0 262322INJECTION LUMBAR
SACRA508- 0508- 0- 0 264400N BLOCK INJ TRIGEMINAL434- 0- 0- 0- 0
264401N BLOCK INJ TRIGEMINAL772- 0- 0- 0- 0 264402N BLOCK INJ
FACIAL729- 0729- 0- 0 264405N BLOCK INJ OCCIPITAL1,201- 01,201- 0-
0 264450NERVE BLOCK PERIPHERAL960- 0960- 0- 0 264451INJ ANE PERIPH
NRV/BRANCH441- 0- 0- 0- 0 265205REM FB EXT EYE140- 0- 0- 0- 0
265206REMOVE FB EXT EYE CONJ SUPERFIC294- 0- 0- 0- 0 265210REM FB
CONJUNTIVAL EMBEDDED- 0161- 0- 0- 0 265211EX FB EXT EYE CONJ
EMBED294- 0- 0- 0- 0 265220FB REMOVAL CORNEAL W/O161- 0- 0- 0- 0
265221REMOVE FB EXT EYE CORNL WO LAMP294- 0- 0- 0- 0 265222REM FB
EXTERNAL EYE239- 0- 0- 0- 0 265223REMOVAL FB EXT EYE CORNL
W/LAMP261- 0- 0- 0- 0 265435REMOVAL CORNEAL EPITHELIUM178178- 0- 0-
0 265437REMOVAL-CORNEAL EPITHELIUM588- 0- 0- 0- 0
268200SUBCONJUNCTIVAL INJECTION181- 0- 0- 0- 0
268201SUBCONJUNCTIVAL INJECTION294- 0- 0- 0- 0 269000DRAIN EXT EAR
ABSCESS640- 0- 0- 0- 0 269001DRAIN EXT EAR ABSCES SIMPL294- 0- 0-
0- 0 269200FB REM EXT EAR CANAL161- 0- 0- 0- 0 269201REM RB EAC WO
GEN ANES294- 0- 0- 0- 0 269209REMOVE IMPACTED EAR WAX UNI110110110-
0- 0 269211REMOVE IMPACTED EAR WAX UNI53- 053- 0- 0 282270ER OCCULT
BLOOD44- 0- 0- 0- 0 282947ER FINGERSTICK GLUCOSE44- 0- 0- 0- 0
290471IMMUNIZATION ADMIN89- 0- 0- 0- 0 290472IMMUN ADM EA
ADDITIONAL40- 0- 013- 0 290675RABIES VACCINE INTRAMUSCULAR212- 0-
0- 0- 0 290676RABIES VACCINE INTRADERMAL166- 0- 0- 0- 0
290703TETANUS TOXOID ADSORBED IM USE86- 0- 0- 0- 0 290715TETANUS
DIPTHERIA & ACCELLULAR Tdap 7&UP148- 0- 0- 0- 0 290718Td 7
YEARS & OLDER IM USE94- 0- 0- 0- 0 290744HEP B PEDIATRIC /
ADULT 3 DOSE IM123- 0- 0- 0- 0 290772ADDITIONAL IV PUSH DIFF
DRUG200- 0- 0- 0- 0 290774INTRAVENOUS IV INJ - IVP128- 0- 0- 0- 0
292950CARDIOPULMONARY RESUSCITATION1,028- 0- 0- 0- 0
292960CARDIOVERSION ELECTRIC EXT1,694- 0- 0- 0- 0
292977THROMBOLYSIS CORONARY INTRAVENOUS- 0- 0994- 0- 0 296360IV
HYDRATION INITIAL HR446- 0- 0- 0- 0 296361IV HYDRATION EACH ADDL
HR199- 0- 0- 0- 0 296365IV THERAPY 1ST HR541- 0- 0- 0- 0 296366IV
THERAPY EACH ADDL HR212- 0- 0- 0- 0 296367IV THERAPY ADD SEQ
INFUSION262- 0- 0- 0- 0 296368IV INF TX/PROPHYL/DX CONCURRENT236-
0- 0- 0- 0 296369SC THER INFUSION UP TO 1 HR408408408- 0- 0
296372THERAPEUTIC INJ - IM156- 0- 045- 0 296374THERAPEUTIC IV INJ -
IVP304- 0- 0- 0- 0 296375ADDITIONAL IV PUSH DIFF DRUG213- 0- 0- 0-
0 296376ADDITIONAL IV PUSH SAME DRUG197- 0- 0- 0- 0 296523IRRIG
DRUG DELIVERY DEVICE FACILITY183- 0- 0- 0- 0 296524IRRIG DRUG
DELIVERY DEVICE FACITLY75- 0- 0- 0- 0 299281ER FAC LEVEL 1221- 0-
0- 0- 0 299282ER FAC LEVEL 2335- 0335- 0- 0 299283ER FAC LEVEL
3598- 0- 0- 0- 0 299284ER FAC LEVEL 4926- 0- 0- 0- 0 299285ER FAC
LEVEL 51,249- 0- 0- 0- 0 299286ER FEE LEVEL 1128- 0128- 0- 0
299287ER FEE LEVEL 2206- 0206- 0- 0 299288ER FEE LEVEL 3341- 0341-
0- 0 299289ER FEE LEVEL 4535535535- 0- 0 299290ER FEE LEVEL 5792-
0792- 0- 0 299291CRITICAL CARE FIRST HR873- 0- 0- 0- 0
299292CRITICAL CARE EA ADD 30382- 0- 0- 0- 0 299293TRAUMA
ACTIVATION ADD. 30 MIN.558- 0- 0- 0- 0 299998ER JUST LIKE FACILITY
FEE- 0- 0- 0- 0- 0 299999ER JUST LIKE PRO FEE- 0- 0- 0- 0- 0
300030ANTI PROTHROMBIN ANTIBOD175- 0- 0- 0- 0 306300CANCER ANTIGEN
15-3109- 0- 0- 0- 0 306301CARBOHYDRATE AG 19-9- 0- 0- 0- 0- 0
306304CANCER ANTIGEN 125- 0- 0- 0- 0- 0 308304IGF BIND PR 2116- 0-
0- 0- 0 387066CULTURE SPUTUM101- 0- 0- 0- 0 390105COLORECTAL SCRN;
HI RISK IND MEDICARE893893- 0- 0- 0 390121COLON CA SCRN NOT HI RSK
IND MEDICARE893893- 0- 0- 0 410021FINE NEEDLE ASPIRATION624- 0- 0-
0- 0 410022FINE NEEDLE ASP W/IMAGING319- 0- 0- 0- 0 410060I & D
ABCESS SIMPLE646- 0- 0- 0- 0 410061I & D ABSCESS COMP OR
MULTI961- 0- 0- 0- 0 410081I & D PILONIDAL CYST- 02,100- 0- 0-
0 410121INC & REM FOREIGN BODY COMP3,388- 0- 0- 0- 0 410140I
& D OF HEMATOMA SIMPLE2,679- 0- 0- 0- 0 410180I & D COMP
POSTOP INFECTION3,348- 0- 0- 0- 0 411000DEBRIDEMENT EXTENS
ECZ1,709- 0- 0- 0- 0 411010DEBRIDE FB OPEN FRACTURE1,373- 0- 0- 0-
0 411011DEBRIDE SKIN/MUSCLE FX1,542- 0- 0- 0- 0 411012DEBRDMT
FOREIGN MAT OPEN FX1,661- 0- 0- 0- 0 411040DEBRIDEMENT SKIN PRT1
THICKNESS- 0- 0- 0- 0- 0 411042DEBRID SKIN SUBCUT TISSUE1,746- 0-
0- 0- 0 411043DEBRIDE TISSUE/MUSCLE1,910- 0- 0- 0- 0
411044DEBRIDEMENT, BONE2,460- 0- 0- 0- 0 411100BIOPSY SKIN LESION-
01,049- 0- 0- 0 411101BIOPSY SKIN ADD-ON- 0372- 0- 0- 0
411402EXCISION OF BENIGN LESION 1.1 TO 2CM- 0- 0- 0- 0- 0 411403EX
BEN LES 2.1 TO 3.0 CM2,303- 0- 0- 0- 0 411404EX BENIGN LESION
3.1-42,979- 0- 0- 0- 0 411406EX BENIGN LESION OVER 4.0 CM3,345- 0-
0- 0- 0 411420EXCISION BENIGN LES SC- 0- 0- 0- 0- 0 411421EX BEN
LES .6 TO 1. CM1,904- 0- 0- 0- 0 411422EX BENIGN LESION 1.1 TO 2.0
CM2,327- 0- 0- 0- 0 411423EXC LESION BENIGN 2.1 TO 3.0 CM- 03,548-
0- 0- 0 411424EXC BENIGN LESION 3.1 X 4.0CM3,411- 0- 0- 0- 0
411426EX BENIGN LESION < 4.0 CM3,778- 0- 0- 0- 0 411440EXCISION
B LESION .5CM1,358- 0- 0- 0- 0 411441EX BENIGN LESION .6-1.0
CM1,454- 0- 0- 0- 0 411442EX BENIGN LESION 1.1 - 2.02,235- 0- 0- 0-
0 411443EX BENIGN LESION 2.1 - 3.0CM2,460- 0- 0- 0- 0 411444EXC
BENIGN LESION 3.1-4.02,972- 0- 0- 0- 0 411450REMOVAL SWEAT GLAND
LESION- 05,245- 0- 0- 0 411604EXCISION MALIGNANT LESION- 02,581- 0-
0- 0 411606EXCISION MALIGRANT LES- 0- 0- 0- 0- 0 411642EX MALIG
LESION 1.1-2.0 CM2,213- 0- 0- 0- 0 411730REMOVAL OF BED PLATE-
0558- 0- 0- 0 411750EXCISION OF NAIL & MATRIX1,384- 0- 0- 0- 0
411770EX OF PILONIDAL CYST OR SINUS SIMPLE5,483- 0- 0- 0- 0
411771REMOVE PILONIDAL CYST EXTEN5,848- 0- 0- 0- 0 412001REPAIR
SIMPLE 2.5 OR LESS412- 0- 0- 0- 0 412002REPAIR SIMPLE 2.6-7.5
CM406- 0- 0- 0- 0 412004SIMPLE REPAIR 7.6-12.5CM472- 0- 0- 0- 0
412014SIMPLE REPAIR SUPERFICIAL WOUNDS442- 0- 0- 0- 0 412031REPAIR
INTERM 2.5 CM OR LESS598- 0- 0- 0- 0 412032REPAIR INTERM WOUND
SCALP559- 0- 0- 0- 0 412037REPAIR INTERMED WOUND OVER 30.0 CM1,164-
0- 0- 0- 0 412042REPAIR INTERM 2.6-7.5CM547- 0- 0- 0- 0
412045REPAIR ITERM NECK, HANDS 12.6-20.0578- 0- 0- 0- 0
412052REPAIR INTERM WOUND FACE502- 0- 0- 0- 0 413101REPAIR
LACERATION TRUNK1,363- 0- 0- 0- 0 413121REPAIR COMPLEX SCALPAR- 0-
0- 0- 0- 0 413122REPAIR COMPLEX SCALP AR- 0- 0- 0- 0- 0
413131REPAIR COMPLEX 1.1CM-2.5CM705- 0- 0- 0- 0 413133REPAIR
WOUND/LESION ADD-ON- 0773- 0- 0- 0 413151REPAIR COMPLEX EYELIDS
1.1-2.5 CM1,164- 0- 0- 0- 0 413152REPAIR COMPLEX 2.6-7.5 C1,254- 0-
0- 0- 0 413153REPAIR COMPLEX 5CM 1,3091,309- 0- 0- 0 3921931EXC
BACK LES SC 3 CM/>1,3091,309- 0- 0- 0 3921933EXC BACK TUM DEEP 5
CM/>1,9251,925- 0- 0- 0 3923020RELEASE SHOULDER JOINT2,1882,188-
0- 0- 0 3923120PARTIAL REMOVAL COLLAR BONE1,5401,540- 0- 0- 0
3923125REMOVAL OF COLLAR BONE3,2923,292- 0- 0- 0 3923130REMOVE
SHOULDER BONE PART1,5401,540- 0- 0- 0 3923405INCISION OF TENDON
& MUSCLE1,6451,645- 0- 0- 0 3923410REPAIR ROTATOR CUFF
ACUTE2,4502,450- 0- 0- 0 3923412REPAIR ROTATOR CUFF
CHRONIC2,9232,923- 0- 0- 0 3923420REPAIR OF SHOULDER3,3253,325- 0-
0- 0 3923430REPAIR BICEPS TENDON2,1002,100- 0- 0- 0 3923455REPAIR
SHOULDER CAPSULE3,5353,535- 0- 0- 0 3923470RECONSTRUCT SHOULDER
JOINT3,7403,740- 0- 0- 0 3923472RECONSTRUCT SHOULDER
JOINT6,4756,475- 0- 0- 0 3923515TREAT CLAVICLE FRACTURE1,6841,684-
0- 0- 0 3923655TREAT SHOULDER DISLOCATION879879- 0- 0- 0
3923931DRAINAGE OF ARM BURSA611611- 0- 0- 0 3924105REMOVAL OF ELBOW
BURSA963963- 0- 0- 0 3924147PARTIAL REMOVAL OF ELBOW1,4531,453- 0-
0- 0 3924305ARM TENDON LENGTHENING1,1201,120- 0- 0- 0 3924340REPAIR
OF BICEPS TENDON2,4502,450- 0- 0- 0 3924341REPAIR ARM
TENDON/MUSCLE2,2752,275- 0- 0- 0 3924358REPAIR ELBOW W/DEB
OPEN1,4001,400- 0- 0- 0 3924359REPAIR ELBOW DEB/ATTCH
OPEN1,8501,850- 0- 0- 0 3924556TREAT RADIUS FRACTURE1,4001,400- 0-
0- 0 3924600TREAT ELBOW DISLOCATION490- 0490- 0- 0 3924605TREAT
ELBOW DISLOCATION613613613- 0- 0 3924620TREAT ELBOW FRACTURE1,050-
0- 0- 0- 0 3924665TREAT RADIUS FRACTURE1,4001,400- 0- 0- 0
3924685TREAT ULNAR FRACTURE1,4531,453- 0- 0- 0 3925000INCISION OF
TENDON SHEATH945945- 0- 0- 0 3925101EXPLORE/TREAT WRIST
JOINT1,1381,138- 0- 0- 0 3925111REMOVE WRIST TENDON LESION945945-
0- 0- 0 3925150PARTIAL REMOVAL OF ULNA1,3091,309- 0- 0- 0
3925405REPAIR/GRAFT RADIUS OR ULNA2,6832,683- 0- 0- 0 3925447REPAIR
WRIST JOINTS2,8052,805- 0- 0- 0 3925515TREAT FRACTURE OF
RADIUS1,5931,593- 0- 0- 0 3925530TREAT FRACTURE OF ULNA630630- 0-
0- 0 3925545TREAT FRACTURE OF ULNA1,5751,575- 0- 0- 0 3925565TREAT
FRACTURE RADIUS & ULNA1,1381,138- 0- 0- 0 3925605TREAT FRACTURE
RADIUS/ULNA788788- 0- 0- 0 3925607TREAT FX RAD
EXTRA-ARTICUL2,3632,363- 0- 0- 0 3925608TREAT FX RAD
INTRA-ARTICUL2,6952,695- 0- 0- 0 3925609TREAT FX RADIAL 3+
FRAG3,4653,465- 0- 0- 0 3925652TREAT FRACTURE ULNAR
STYLOID1,7681,768- 0- 0- 0 3925810FUSION/GRAFT OF WRIST
JOINT2,4502,450- 0- 0- 0 3926011DRAINAGE OF FINGER ABSCESS730730-
0- 0- 0 3926020DRAIN HAND TENDON SHEATH1,1411,141- 0- 0- 0
3926030DRAINAGE OF PALM BURSAS2,0202,020- 0- 0- 0 3926055INCISE
FINGER TENDON SHEATH945945- 0- 0- 0 3926111EXC HAND LES SC 1.5
CM/>1,1031,103- 0- 0- 0 3926113EXC HAND TUM DEEP 1.5
CM/>1,4961,496- 0- 0- 0 3926115EXC HAND LES SC < 105
CM630630- 0- 0- 0 3926116EXC HAND TUM DEEP < 1.5 CM1,1231,123-
0- 0- 0 3926123RELEASE PALM CONTRACTURE2,4502,450- 0- 0- 0
3926125RELEASE PALM CONTRACTURE1,0501,050- 0- 0- 0 3926160REMOVE
TENDON SHEATH LESION840840- 0- 0- 0 3926210REMOVAL OF FINGER
LESION1,2251,225- 0- 0- 0 3926236PARTIAL REMOVAL FINGER BONE963963-
0- 0- 0 3926320REMOVAL OF IMPLANT FROM HAND1,0501,050- 0- 0- 0
3926410REPAIR HAND TENDON893893- 0- 0- 0 3926412REPAIR/GRAFT HAND
TENDON1,3481,348- 0- 0- 0 3926418REPAIR FINGER TENDON875875- 0- 0-
0 3926455INCISION OF FINGER TENDON1,1221,122- 0- 0- 0
3926508RELEASE THUMB CONTRACTURE1,4001,400- 0- 0- 0 3926530REVISE
KNUCKLE JOINT1,400- 0- 0- 0- 0 3926605TREAT METACARPAL
FRACTURE524524- 0- 0- 0 3926608TREAT METACARPAL FRACTURE1,4181,418-
0- 0- 0 3926615TREAT METACARPAL FRACTURE1,3481,348- 0- 0- 0
3926727TREAT FINGER FRACTURE EACH685685- 0- 0- 0 3926735TREAT
FINGER FRACTURE EACH1,1551,155- 0- 0- 0 3926755TREAT FINGER
FRACTURE EACH210210- 0- 0- 0 3926765TREAT FINGER FRACTURE
EACH814814- 0- 0- 0 3926785TREAT FINGER DISLOCATION618618- 0- 0- 0
3926841FUSION OF THUMB1,4001,400- 0- 0- 0 3926842THUMB FUSION WITH
GRAFT1,7681,768- 0- 0- 0 3926951AMPUTATION OF
FINGER/THUMB1,1031,103- 0- 0- 0 3926952AMPUTATION OF
FINGER/THUMB1,4181,418- 0- 0- 0 3926989HAND/FINGER SURGERY- 0- 0-
0- 0- 0 3927040BIOPSY OF SOFT TISSUES315315- 0- 0- 0 3927045EXC
HIP/PELV TUM DEEP 5 CM/>1,9251,925- 0- 0- 0 3927062REMOVE FEMUR
LESION/BURSA770770- 0- 0- 0 3927095INJECTION FOR HIP X-RAY700700-
0- 0- 0 3927096INJ PROC SACROILIAC JOI493- 0- 0- 0- 0 3927130TOTAL
HIP ARTHROPLASTY5,6885,688- 0- 0- 0 3927235TREAT THIGH
FRACTURE3,6753,675- 0- 0- 0 3927236TREAT THIGH FRACTURE4,7254,725-
0- 0- 0 3927244TREAT THIGH FRACTURE3,4483,448- 0- 0- 0 3927245TREAT
THIGH FRACTURE4,4804,480- 0- 0- 0 3927252TREAT HIP
DISLOCATION840840840- 0- 0 3927257TREAT HIP DISLOCATION2,886-
02,886- 0- 0 3927266TREAT HIP DISLOCATION963963- 0- 0- 0
3927299REVISION OF THIGH MUSCLES2,8992,899- 0- 0- 0 3927301DRAIN
THIGH/KNEE LESION666666- 0- 0- 0 3927305INCISE THIGH TENDON &
FASCIA1,208- 0- 0- 0- 0 3927310EXPLORATION OF KNEE JOINT2,1882,188-
0- 0- 0 3927328EXC THIGH/KNEE TUM DEEP &1T 5CM1,2161,216- 0- 0-
0 3927334REMOVE KNEE JOINT LINING3,1503,150- 0- 0- 0 3927345REMOVAL
OF KNEE CYST1,8521,852- 0- 0- 0 3927380REPAIR OF KNEECAP
TENDON2,0572,057- 0- 0- 0 3927385REPAIR OF THIGH MUSCLE2,3632,363-
0- 0- 0 3927407REPAIR OF KNEE LIGAMENT2,975275- 0- 0- 0
3927416OSTEOCHONDRAL KNEE AUTOGRAFT2,7752,775- 0- 0- 0
3927418REPAIR DEGENERATED KNEECAP3,8853,885- 0- 0- 0
3927422REVISION OF UNSTABLE KNEECAP2,8992,899- 0- 0- 0 3927425LAT
RETINACULAR RELEASE OPEN2,8002,800- 0- 0- 0 3927427RECONSTRUCTION
KNEE3,3253,325- 0- 0- 0 3927430REVISION OF THIGH MUSCLES2,7132,713-
0- 0- 0 3927447TOTAL KNEE ARTHROPLASTY4,900- 0- 0- 0- 0
3927457REALIGNMENT OF KNEE2,7132,713- 0- 0- 0 3927486REVISE/REPLACE
KNEE JOINT3,9963,996- 0- 0- 0 3927487REVISE/REPLACE KNEE
JOINT7,8757,875- 0- 0- 0 3927495REINFORCE THIGH2,4502,450- 0- 0- 0
3927524TREAT KNEECAP FRACTURE2,2442,244- 0- 0- 0 3927535TREAT KNEE
FRACTURE2,2232,223- 0- 0- 0 3927552TREAT KNEE DISLOCATION665665- 0-
0- 0 3927562TREAT KNEECAP DISLOCATION740- 0740- 0- 0 3927603DRAIN
LOWER LEG LESION963963- 0- 0- 0 3927650REPAIR ACHILLES
TENDON1,9251,925- 0- 0- 0 3927685REVISION OF LOWER LEG
TENDON1,3281,328- 0- 0- 0 3927690REVISE LOWER LEG TENDON1,4961,496-
0- 0- 0 3927691REVISE LOWER LEG TENDON1,0501,050- 0- 0- 0
3927692REVISE ADDITIONAL LEG TENDON374374- 0- 0- 0 3927696REPAIR OF
ANKLE LIGAMENTS2,4502,450- 0- 0- 0 3927752TREATMENT OF TIBIA
FRACTURE1,2951,295- 0- 0- 0 3927758TREATMENT OF TIBIA
FRACTURE2,3752,375- 0- 0- 0 3927786TREATMENT OF ANKLE
FRACTURE555555- 0- 0- 0 3927788TREATMENT OF ANKLE FRACTURE700-
0700- 0- 0 3927792TREATMENT OF ANKLE FRACTURE1,6101,610- 0- 0- 0
3927810TREATMENT OF ANKLE FRACTURE875- 0875- 0- 0 3927814TREATMENT
OF ANKLE FRACTURE2,1882,188- 0- 0- 0 3927822TREATMENT OF ANKLE
FRACTURE2,5382,538- 0- 0- 0 3927870FUSION OF ANKLE JOINT
OPEN3,0453,045- 0- 0- 0 3927880AMPUTATION OF LOWER LEG2,5382,538-
0- 0- 0 3928022EXPLORATION OF FOOT JOINT823823- 0- 0- 0 3928039EXC
FOOT/TOE TUM SC 1.5 CM/>1,3481,348- 0- 0- 0 3928046RESECT
FOOT/TOE TUMOR < 3 CM2,1002,100- 0- 0- 0 3928080REMOVAL OF FOOT
LESION1,0101,010- 0- 0- 0 3928090REMOVAL OF FOOT LESION861861- 0-
0- 0 3928104REMOVAL OF FOOT LESION945945- 0- 0- 0 3928108REMOVAL OF
TOE LESIONS823823- 0- 0- 0 3928119REMOVAL OF HEEL SPUR963963- 0- 0-
0 3928120PART REMOVAL OF ANKLE/HEEL1,2211,221- 0- 0- 0
3928122PARTIAL REMOVAL OF FOOT BONE928928- 0- 0- 0 3928124PARTIAL
REMOVAL OF TOE700700- 0- 0- 0 3928160PARTIAL REMOVAL OF TOE840840-
0- 0- 0 3928232INCISION OF TOE TENDON298298- 0- 0- 0
3928234INCISION OF FOOT TENDON210210- 0- 0- 0 3928238REVISION OF
FOOT TENDON1,3301,330- 0- 0- 0 3928270RELEASE OF FOOD
CONTRACTURE455455- 0- 0- 0 3928285REPAIR OF HAMMERTOE928928- 0- 0-
0 3928288PARTIAL REMOVAL OF A FOOT BONE928928- 0- 0- 0 3928289CORRJ
HALUX RIGDUS W/O IMPLT1,0181,018- 0- 0- 0 3928291CORRJ JALUX RAGDUS
W/IMPLT1,3141,314- 0- 0- 0 3928295CORRECTION HALLUX
VALGUS1,4961,496- 0- 0- 0 3928296CORRECTION OF BUNION2,1882,188- 0-
0- 0 3928299CORRECTION HALLUX VALGUS2,3132,313- 0- 0- 0
3928300INCISION OF HEEL BONE1,6801,680- 0- 0- 0 3928308INCISION OF
METATARSAL1,0361,036- 0- 0- 0 3928315REMOVAL OF SESAMOID
BONE700700- 0- 0- 0 3928630TREAT TOE DISLOCATION426- 0426- 0- 0
3928675REPAIR OF TOE DISLOCATION861861- 0- 0- 0 3928735FUSION OF
FOOT BONES2,4502,450- 0- 0- 0 3928800AMPUTATION OF
MIDFOOT1,9641,964- 0- 0- 0 3928810AMPUTATION TOE &
METATARSAL1,0731,073- 0- 0- 0 3928820AMPUTATION OF TOE630630- 0- 0-
0 3928825PARTIAL AMPUTATION OF TOE630630- 0- 0- 0 3929085APPLY
HAND/WRIST CAST113113- 0- 0- 0 3929445APPLY RIGID LEG CAST296296-
0- 0- 0 3929700REMOVAL/REVISION OF CAST70- 070- 0- 0
3929806SHOULDER ARTHROSCOPY/SURGERY3,3853,385- 0- 0- 0
3929807SHOULDER ARTHROSCOPY/SURGERY3,2923,292- 0- 0- 0
3929822SHOULDER ARTHROSCOPY/SURGERY2,8882,888- 0- 0- 0
3929824SHOULDER ARTHROSCOPY/SURGERY1,9251,925- 0- 0- 0
3929826SHOULDER ARTHROSCOPY/SURGERY2,6952,695- 0- 0- 0
3929827ARTHROSCOP RORATOR CUFF RPR3,8153,815- 0- 0- 0
3929828ARTHROSCOPY BICEPS TENODESIS2,4852,485- 0- 0- 0
3929866AUTGRFT IMPLNT KNEE W/SCOPE3,0713,071- 0- 0- 0 3929870KNEE
ARTHROSCOPY DX1,5401,540- 0- 0- 0 3929871KNEE
ARTHROSCOPY/DRAINAGE1,4531,453- 0- 0- 0 3929873KNEE
ARTHROSCOPY/SURGERY2,2052,205- 0- 0- 0 3929874KNEE
ARTHROSCOPY/SURGERY2,0572,057- 0- 0- 0 3929875KNEE
ARTHROSCOPY/SURGERY2,6952,695- 0- 0- 0 3929876KNEE
ARTHROSCOPY/SURGERY3,4653,465- 0- 0- 0 3929877KNEE
ARTHROSCOPY/SURGERT2,6952,695- 0- 0- 0 3929879KNEE
ARTHROSCOPY/SURGERT2,6952,695- 0- 0- 0 3929880KNEE
ARTHROSCOPY/SURGERY3,483- 0- 0- 0- 0 3929881KNEE
ARTHROSCOPY/SURGERY2,6952,695- 0- 0- 0 3929882KNEE
ARTHROSCOPY/SURGERY3,3783,378- 0- 0- 0 3929884KNEE ARTHROSCOPY
SURGERY3,0803,080- 0- 0- 0 3929888KNEE
ARTHROSCOPY/SURGERY5,9685,968- 0- 0- 0 3930140RESECT INFERIOR
TURBINATE1,0661,066- 0- 0- 0 3930520REPAIR OF NASAL
SEPTUM2,0572,057- 0- 0- 0 3930802ABLATE INF TURBINATE SUBMUC300300-
0- 0- 0 3930901CONTROL OF NOSEBLEED187187- 0- 0- 0 3931253NSL/SINS
NDSC TOTAL2,6182,618- 0- 0- 0 3931256EXPLORATION MAXILLARY
SINUS935935- 0- 0- 0 3931257NSL/SINS NDSC TOT W/SPHENDT2,2442,244-
0- 0- 0 3931575DIAGNOSTIC LARYNGOSCOPY337337- 0- 0- 0
3932422THORACENTESIS W/TUBE INSERT- 0- 0- 0- 0- 0 3932551INSERTION
OF CHEST TUBE555555- 0- 0- 0 3932554ASPIRATE PLEURA W/O IMAGING228-
0228- 0- 0 3932555ASPIRATE PLEURA W/IMAGING300300- 0- 0- 0
3936510INSERTION OF CATHETER VEIN185- 0- 0- 0- 0 3936567INSERT PICC
CATH158158- 0- 0- 0 3936569INSERT PICC CATH158158- 0- 0- 0
3936571INSERT PICVAD CATH525- 0- 0- 0- 0 3936589REMOVAL TUNNELED CV
CATH259259- 0- 0- 0 3936590REMOVAL TUNNELED CV CATH333333- 0- 0- 0
3937609TEMPORAL ARTERY PROCEDURE350350- 0- 0- 0 3938120LAPAROSCOPY
SPLENECTOMY3,7483,748- 0- 0- 0 3938220BONE MARROW ASPIRATION175- 0-
0- 0- 0 3938221BONE MARROW BIOPSY228228228- 0- 0 3941010INCISION OF
TONGUE FOLD337337- 0- 0- 0 3941100BIOPSY OF TONGUE167167- 0- 0- 0
3941113EXC OF TONGUE LESION333333333- 0- 0 3941250REPAIR TONGUE
LACERATION245- 0245- 0- 0 3942000DRAINAGE MOUTH ROOF LESION185- 0-
0- 0- 0 3942330REMOVAL OF SALIVARY STONE158- 0158- 0- 0
3942820REMOVE TONSILS AND ADENOIDS1,1411,141- 0- 0- 0
3942826REMOVAL OF TONSILS1,1971,197- 0- 0- 0 3943235EGD DIAGNOSTIC
BRUSH WASH777777- 0- 0- 0 3943239EGD BIOPSY SINGLE/MULTIPLE753- 0-
0- 0- 0 3943251EGD REMOVE LESION SNARE945945- 0- 0- 0
3944120REMOVAL OF SMALL INTESTINE3,3953,395- 0- 0- 0 3944140PARTIAL
REMOVAL OF COLON3,2383,238- 0- 0- 0 3944376SMALL BOWEL
ENDOSCOPY3,5503,550- 0- 0- 0 3944620REPAIR BOWEL OPENING1,925- 0-
0- 0- 0 3944950APPENDECTOMY2,013- 0- 0- 0- 0 3944970LAPAROSCOPY
APPENDENTOMY3,4133,413- 0- 0- 0 3945300PROCTOSIGMOIDOSCOPY
DX130130- 0- 0- 0 3945330DIAGNOSTIC SIGMOIDOSCOPY228228- 0- 0- 0
3945378DIAGNOSTIC COLONOSCOPY670- 0- 0- 0- 0 3945380COLONSCOPY AND
BIOPSY1,155- 0- 0- 0- 0 3945384COLONOSCOPY W/LESION
REMOVAL1,2951,295- 0- 0- 0 3945385COLONOSCOPY W/LESION
REMOVAL1,4001,400- 0- 0- 0 3945393COLONOSCOPY W/DECOMPRESSION1,055-
0- 0- 0- 0 3946040INCISION OF RECTAL ABSCESS525525- 0- 0- 0
3946050INCISION OF ANAL ABSCESS175175- 0- 0- 0 3946083INCISE
EXTERNAL HEMORRHOID175- 0175- 0- 0 3946200REMOVAL OF ANAL
FISSURE823823- 0- 0- 0 3946221LIGATION OF HEMORRHOID(S)289289-
0289- 0 3946606ANOSCOPY AND BIOPSY204204- 0- 0- 0 3947000NEEDLE
BIOPSY OF LIVER374374- 0- 0- 0 3947350REPAIR LIVER WOUND2,9752,975-
0- 0- 0 3947361REPAIR LIVER WOUND7,0007,000- 0- 0- 0
3947379LAPAROSCOPE PROCEDURE LIVER2,9052,905- 0- 0- 0
3947562LAPAROSCOPIC CHOLECYSTECTOMY3,238- 0- 0- 0- 0 3947563LAPARO
CHOLESYSTECTOMR/GRAPH3,6403,6403,640- 0- 0 3947600REMOVAL OF
GALLBLADDER2,8532,853- 0- 0- 0 3947605REMOVAL OF
GALLBLADDER3,2203,220- 0- 0- 0 3949000EXPLORATION OF
ABDOMEN2,4052,405- 0- 0- 0 3949082ABD PARACENTESIS263263- 0- 0- 0
3949083ABD PARACENTESIS W/IMAGING438438- 0- 0- 0 3949084PERITONEAL
LAVAGE438438- 0- 0- 0 3949320DIAG LAPARO SEPARATE PROC1,8201,820-
0- 0- 0 3949321LAPAROSCOPY BIOPSY1,8701,870- 0- 0- 0
3949322LAPAROSCOPY ASPIRATION1,8701,870- 0- 0- 0 3949329LAPARO PROC
ABDM/PER/OMENT1,9451,945- 0- 0- 0 3949505RPR I/HERN INIT REDUC>5
YR1,715- 0- 0- 0- 0 3949507PRP I/HERN INIT BLOCK >5
YR2,2752,275- 0- 0- 0 3949520REREPAIR ING HERNIA REDUCE2,2232,223-
0- 0- 0 3949525REPAIR ING HERNIA SLIDING1,8201,820- 0- 0- 0
3949553RPR FEM HERNIA INIT BLOCKED2,3632,363- 0- 0- 0 3949560RPR
VENTRAL HERN INIT REDUC2,3102,310- 0- 0- 0 3949565REREPAIR VENTRL
HERN REDUCE2,6252,625- 0- 0- 0 3949566REREPAIR VENTRL HERN
BLOCK3,1853,185- 0- 0- 0 3949568HERNIA REPAIR W/MESH350350- 0- 0- 0
3949572RPR EPIGASTRIC HERN BLOCKED1,3651,365- 0- 0- 0 3949585RPR
UMBIL HERN REDUC> 5 YR1,610- 0- 0- 0- 0 3949587RPR UMBIL HERN
BLOCK > 5 YR2,1702,170- 0- 0- 0 3949590REPAIR SPIGELIAN
HERNIA1,8201,820- 0- 0- 0 3949655LAP INC HERN REPAIR
COMP2,8882,888- 0- 0- 0 3949900REPAIR OF ABDONIMAL WALL1,2951,295-
0- 0- 0 3950590FRAGMENTING OF KIDNEY STONE6,5636,563- 0- 0- 0
3951050REMOVAL OF BLADDER STONE2,2202,220- 0- 0- 0 3951102DRAIN BL
W/CATH INSERTION740- 0740- 0- 0 3951703INSERT BLADDER CATH
COMPLEX105105- 0- 0- 0 3951720TREATMENT OF BLADDER LESION140140- 0-
0- 0 3952000CYSTOSCOPY350350- 0- 0- 0 3952005CYSTOSCOPY &
URETER CATHETER525525- 0- 0- 0 3952204CYSTOSCOPY W/BIOPSY(S)368368-
0- 0- 0 3952214CYSTOSCOPY AND TREATMENT389389- 0- 0- 0
3952224CYSTOSCOPY AND TREATMENT368368- 0- 0- 0 3952234CYSTOSCOPY
AND TREATMENT718718- 0- 0- 0 3952235CYCTOSCOPY AND
TREATMENT1,5541,554- 0- 0- 0 3952240CYCTOSCOPY AND
TREATMENT2,2052,205- 0- 0- 0 3952260CYSTOSCOPY AND TREATMENT368- 0-
0- 0- 0 3952275CYSTOSCOPY & REVISE URETHRA438438- 0- 0- 0
3952276CYSTOSCOPY AND TREATMENT980980- 0- 0- 0 3952281CYSTOSCOPY
AND TREATMENT525525- 0- 0- 0 3952285CYSTOSCOPY AND TREATMENT368368-
0- 0- 0 3952287CYSTOSCOPY CHEMODENERVATION592- 0- 0- 0- 0
3952310CYSTOSCOPY AND TREATMENT490490- 0- 0- 0 3952330CYSTOSCOPY
AND TREATMENT613613- 0- 0- 0 3952332CYSTOSCOPY AND TREATMENT613613-
0- 0- 0 3952351CYSTOURETERO & OR PYELOSCOPE1,5401,540- 0- 0- 0
3952352CYSTOURETERO W/STONE REMOVE1,9601,960- 0- 0- 0
3952601PROSTATECTOMY (TURP)3,5003,500- 0- 0- 0 3952630REMOVE
PROSTATE REGROWTH3,500- 0- 0- 0- 0 3953025INCISION OF URETHRA8888-
0- 0- 0 3953260TREATMENT OF URETHRA LESION175175- 0- 0- 0
3953665DILATION OF URETHRA228228- 0- 0- 0 3953850PROSTATIC
MICROWAVE THERMOTX1,9251,925- 0- 0- 0 3953852PROSTATIC RF
THERMOTX2,0132,013- 0- 0- 0 3954055DESTRUCTION PENIS
LESION(S)185185- 0- 0- 0 3954060EXCISION OF PENIS LESION(S)350350-
0- 0- 0 3954100BIOPSY OF PENIS130130- 0- 0- 0 3954150CIRCUMCISION
W/REGIONAL BLOCK298298- 0- 0- 0 3954161CIRCUM 28 DAYS OR
OLDER473473- 0- 0- 0 3954162LYSIS PENILE CIRCUMIC LESION700700- 0-
0- 0 3954520EXCISION PROCEDURES ON THE TESTIS407407- 0- 0- 0
3954640SUSPENSION OF TESTIS2,4692,469- 0- 0- 0 3954700DRAINAGE OF
SCROTUM259- 0259- 0- 0 3954840REMOVE EPIDIDYMIS LESION1,6101,610-
0- 0- 0 3955000DRAINAGE OF HYDROCELE5757- 0- 0- 0 3955040REMOVAL OF
HYDROCELE1,6101,610- 0- 0- 0 3955250VASECTOMY1,8201,820- 0- 0- 0
3955700BIOPSY OF PROSTATE245- 0- 0- 0- 0 3956405I & D OF
VULVA/PERINEUM487487- 0- 0- 0 3956515DESTROY VULVA LESION/S
COMPL910910- 0- 0- 0 3957120CLOSURE OF VAGINA2,3632,363- 0- 0- 0
3957135REMOVE VAGINA LESION685685- 0- 0- 0 3957220REVISION OF
URETHRA1,8331,833- 0- 0- 0 3957240REPAIR BLADDER &
VAGINA1,1631,163- 0- 0- 0 3957250REPAIR RECTUM &
VAGINA1,5401,540- 0- 0- 0 3957288REPAIR BLADDER DEFECT3,1853,185-
0- 0- 0 3957300REPAIR RECTUM-VAGINA FISTULA2,3632,363- 0- 0- 0
3957420EXAM OF VAGINA W/SCOPE431431- 0- 0- 0 3957421EXAM/BIOPSY OF
VAG W/SCOPE481- 0- 0- 0- 0 3957522CONIZATION OF CERVIX910- 0- 0- 0-
0 3957800DILATION OF CERVICAL CANAL105105- 0- 0- 0 3958120DILATION
AND CURETTAGE910910- 0- 0- 0 3958150TOTAL HYSTERECTOMY3,6263,626-
0- 0- 0 3958260VAGINAL HYSTERECTOMY3,8333,833- 0- 0- 0 3958291VAG
HYST INCL T/O COMPLEX5,1435,143- 0- 0- 0 3958300INSERT INTRAUTERINE
DEVICE263263- 0- 0- 0 3958353ENDOMETR ABLATE THERMAL788788- 0- 0- 0
3958550LAPARO-ASST VAG HYSTERECTOMY3,7403,740- 0- 0- 0
3958552LAPARO-VAG HYST INCL T/O4,1484,148- 0- 0- 0
3958558HYSTEROSCOPY BIOPSY735735- 0- 0- 0 3958563HYSTEROSCOPY
ABLATION2,5902,590- 0- 0- 0 3958565HYSTEROSCOPY
STERILIZATION1,2781,278- 0- 0- 0 3958600DIVISION OF FALLOPIAN
TUBE2,0132,013- 0- 0- 0 3958605DIVISION OF FALLOPIAN
TUBE1,5911,591- 0- 0- 0 3958611LIGATE OVIDUCT(S) ADD-ON700700- 0-
0- 0 3958615OCCLUDE FALLOPIAN TUBE(S)1,6981,698- 0- 0- 0
3958660LAPAROSCOPY LYSIS2,4052,405- 0- 0- 0 3958661LAPAROSCOPY
REMOVE ADNEXA2,720- 0- 0- 0- 0 3958662LAPAROSCOPY EXCISE
LESIONS2,4312,431- 0- 0- 0 3958670LAPAROSCOPY TUBAL
CAUTERY2,4052,405- 0- 0- 0 3958671LAPAROSCOPY TUBAL
BLOCK2,2752,275- 0- 0- 0 3958720REMOVAL OF OVARY/TUBES2,9762,976-
0- 0- 0 3959151TREAT ECTOPIC PREGNANCY3,8713,871- 0- 0- 0 3959160D
& C AFTER DELIVERY735735- 0- 0- 0 3959400OB CARE ROUTINE2,901-
0- 0- 0- 0 3959409DELIVERY ONLY1,524- 0- 0- 0- 0 3959410OBSTETRICAL
CARE2,1882,188- 0- 0- 0 3959412ANETEPARTUM MANIPULATION648648- 0-
0- 0 3959414DELIVER PLACENTA2,5382,538- 0- 0- 0 3959425ANTEPARTUM
CARE ONLY925925- 0- 0- 0 3959430CARE AFTER DELIVERY370370- 0- 0- 0
3959510OB ANTEP CSECT POSTPARTUM2,989- 0- 0- 0- 0 3959514CAESAREAN
DELIVERY ONLY1,589- 0- 0- 0- 0 3959610VBAC DELIVERY4,2004,200- 0-
0- 0 3959812TREATMENT OF MISCARRIAGE910910- 0- 0- 0 3959820CARE OF
MISCARRIAGE1,0331,033- 0- 0- 0 3959830TREAT UTERUS
INFECTION1,2031,203- 0- 0- 0 3960100BIOPSY OF THYROID281281- 0- 0-
0 3960300ASPIR/INJ THYROID CYST148148- 0- 0- 0 3962264EPIDURAL
LYSIS ON SINGLE DAY595595- 0- 0- 0 3962270SPINAL FLUID TAP
DIAGNOSTIC350350- 0- 0- 0 3962272DRAIN CEREBRO SPINAL FLUID370370-
0- 0- 0 3962290INJECT FOR SPINE DISK X-RAY525525- 0- 0- 0
3962310INJECT SPINE CERV/THROACIC263- 0- 0- 0- 0 3962311INJECTION
LUMBAR SACRA166166- 0- 0- 0 3962320INJECT SPINE
CERV/THROACIC278278- 0- 0- 0 3962321INJECT SPINE CERV/THROACIC
W/IMAGING296296- 0- 0- 0 3962322INJECTION LUMBAR SACRA241241- 0- 0-
0 3962323INJECTION LUMBAR SACRA W/ IMAGING278278- 0- 0- 0
3962362IMPLANT SPINE INFUSION PUMP1,6461,646- 0- 0- 0 3962365REMOVE
SPINE INFUSION DEVICE1,2721,272- 0- 0- 0 3963650IMPLANT
NEUROELECTRODES1,8201,820- 0- 0- 0 3963661REMOVE SPINE ELTRD PERQ
ARAY1,7501,750- 0- 0- 0 3963685INSRT/REDO SPINE N
GENERATOR1,5931,593- 0- 0- 0 3963688REVISE/REMOVE
NEURORECEIVER1,1201,120- 0- 0- 0 3964400N BLOCK INJ
TRIGEMENAL438438- 0- 0- 0 3964402N BLOCK INJ FACIAL315- 0315- 0- 0
3964405N BLOCK INJ OCCIPITAL123123123- 0- 0 3964406N BLOCK INJ
OCCIPITAL123- 0- 0- 0- 0 3964415N BLOCK INJ BRACHIAL PLEXUS281281-
0- 0- 0 3964421N BLOCK INJ INTERCOST MLT263263- 0- 0- 0 3964425N
BLOCK INJ ILIO/ING/HYPOGI278278- 0- 0- 0 3964450N BLOCK OTHER
PERIPHERAL105105- 0- 0- 0 3964483INJ FORAMEN EPIDURAL L/S175175- 0-
0- 0 3964484INJ FORAMEN EPIDURAL ADD-ON350350- 0- 0- 0 3964490INJ
PARA VERT F JNT C/T 1 LEV525525- 0- 0- 0 3964491INJ PARA VERT F JNT
C/T 2 LEV350350- 0- 0- 0 3964492INJ PARA VERT F JNT C/T 3
LEV350350- 0- 0- 0 3964493INJ PARAVERT F JNT L/S 1 LEV525525- 0- 0-
0 3964494INJ PARA VERT F JNT L/S 2 LEV350350- 0- 0- 0 3964495INJ
PARA VERT F JNT L/S 3 LEV350350- 0- 0- 0 3964510N BLOCK STELLATE
GANGLION228228- 0- 0- 0 3964520N BLOCK LUMBAR/THORACIC263263- 0- 0-
0 3964530N BLOCK INJ CELIAC PELUS228228- 0- 0- 0 3964566NEUROELTRD
STIM POST TIBIAL140140- 0- 0- 0 3964633DESTROY CER/THOR FACET
INT840840- 0- 0- 0 3964634DESTROY C/TH FACET JNT ADDL420420- 0- 0-
0 3964635DESTROY LUMB/SAC FACET JNT840840- 0- 0- 0 3964636DESTROY
L/S FACET JNT ADDL420420- 0- 0- 0 3964640INJ TREATMENT OF
NERVE140140- 0- 0- 0 3964680INJECTION TREATMENT OF NERVE140140- 0-
0- 0 3964704REVISE HAND/FOOT NERVE1,4001,400- 0- 0- 0 3964718REVISE
ULNAR NERVE AT ELBOW1,9251,925- 0- 0- 0 3964719REVISE ULNAR NERVE
AT WRIST1,3831,383- 0- 0- 0 3964721CARPAL TUNNEL SURGERY1,4701,470-
0- 0- 0 3964835REPAIR OF HAND OR FOOT NERVE1,8701,870- 0- 0- 0
3964837REPAIR NERVE ADD-ON1,1221,122- 0- 0- 0 3966821AFTER CATARACT
LASER SURGERY1,1031,103- 0- 0- 0 3966984CATARACT SURG W/IOL 1
STAGE4,9004,900- 0- 0- 0 3969209REMOVE IMPACTED EAR WAX UNI5353- 0-
0- 0 3969436CREATE EARDRUM OPENING748748- 0- 0- 0 3976801US 76801
PRO FEE OB 1ST TRIMESTER97- 0- 0- 0- 0 3976802US 76802 PRO FEE
OB< 14 WEEKS ADDL FETUS78- 0- 0- 0- 0 3976805US 76805 PRO FEE OB
2ND TRIMESTER214- 0- 0- 0- 0 3976810US 76810 PRO FEE OB EA ADDL
GESTATION159- 0- 0- 0- 0 3976811US 76811 PRO FEE OB DETAILED271- 0-
0- 0- 0 3976812US 76812 PRO FEE OB DETAILED ADDL FETUS138- 0- 0- 0-
0 3976815US 76815 PRO FEE OB LMTD H RATE PLAC PLC138- 0- 0- 0- 0
3976816US 76816 PRO FEE OB COMPLETE REPEAT128- 0- 0- 0- 0 3976817US
76817 PRO FEE OB TRANSVAG CX LNGTH97- 0- 0- 0- 0 3976818US 76818
PRO FEE FETAL BPP W NST174- 0- 0- 0- 0 3976819US 76819 PRO FEE
FETAL BPP WO NST169- 0- 0- 0- 0 3976820US 76820 PRO FEE FETAL UMB
ARTERY DPPLR87- 0- 0- 0- 0 3976821US 76821 PRO FEE FETAL MCA
DOPPLER118- 0- 0- 0- 0 3976830US 76830 PRO FEE TRANSVAGINAL169- 0-
0- 0- 0 3976856US 76856 PRO FEE PELVIS159- 0- 0- 0- 0 3990791PSYCH
DIAGNOSTIC EVALUATION624- 0624- 0- 0 3990837PSYTX PT&/FAMILY 60
MINUTES272- 0272272- 0 3992610EVALUATE SWALLOWING FUNCTION488488-
0- 0- 0 3992950HEAT/LUNG RESUSCITATION CPR2,9752,9752,975- 0- 0
3995806SLEEP STUDY UNATT&RESP EFFT540- 0- 0540- 0
3995810POLYSOM 6/> YRS 4/> PARAM782782- 0- 0- 0
3995811POLYSOM 6/> YRS CPAP 4/> PARM850850- 0- 0- 0
3995972ANALYZE NEUROSTIM COMPLEX252252- 0- 0- 0 3997597RMVL DEVITAL
TIS 20 CM/<200200- 0- 0- 0 3997598RMVL DEVITAL TIS ADDL
20CM/<254254- 0- 0- 0 3997605NEG PRESS WOUND TX 3,145-
03,145- 0- 0 3999145MOD SECAT PHYS/QHP EA 15 MIN1,110- 01,110- 0- 0
3999149MOD SED DIFF PHYS/QHP 5/> YRS306306- 0- 0- 0 3999215QTC
PHYSICAL500- 0- 0500- 0 3999217OBSERVATION CARE DISCHA144- 0- 0- 0-
0 3999218INITIAL OBSERVATION CARE 30 MINS192- 0- 0- 0- 0
3999219INITIAL OBSERVATION CARE 50 MINS344- 0- 0- 0- 0
3999220INITIAL OBSERVATION CARE 70 MINS486486- 0- 0- 0
3999221INITIAL HOSPITAL CARE 30 MINS200- 0- 0200- 0 3999222INITIAL
HOSPITAL CARE 50 MINS352- 0- 0- 0- 0 3999223INITIAL HOSPITAL CARE
70 MINS513513- 0- 0- 0 3999224SUBSEQUENT OBSERVATION CARE 15
MINS9090- 0- 0- 0 3999225SUBSEQUENT OBSERVATION CARE 25 MINS177177-
0- 0- 0 3999226SUBSEQUENT OBSERVATION CARE 35 MINS265265- 0- 0- 0
3999231SUBSEQUENT HOSPITAL CARE 15 MINS120- 0- 0- 0- 0
3999232SUBSEQUENT HOSPITAL CARE 25 MINS192- 0- 0- 0- 0
3999233SUBSEQUENT HOSPITAL CARE 35 MINS360360- 0- 0- 0
3999234OBSERV/HOSP SAME DATE414414- 0- 0- 0 3999235OBSERV/HOSP SAME
DATE 50 MINS585585- 0- 0- 0 3999236OBSERV/HOSP SAME DATE 55
MINS702702- 0- 0- 0 3999238HOSPITAL DISCHARGE 30 MINS288- 0- 0- 0-
0 3999239HOSPITAL DISCHARGE DAY540540- 0- 0- 0 3999241OFFICE OR O/P
CONSULTATION 15 MINS216216- 0- 0- 0 3999242OFFICE OR O/P
CONSULTATION 30 MINS306- 0- 0- 0- 0 3999243OFFICE OR O/P
CONSULTATION 40 MINS396396- 0- 0- 0 3999244OFFICE OR O/P
CONSULTATION 60 MINS504504- 0- 0- 0 3999245OFFICE OR O/P
CONSULTATION 80 MINS684684- 0- 0- 0 3999251INPATIENT CONSULTATION
20 MINS234- 0- 0- 0- 0 3999252INPATIENT CONSULTATION 40 MINS324-
0324- 0- 0 3999253INPATIENT CONSULTATION 55 MINS414414- 0- 0- 0
3999254INPATIENT CONSULTATION 80 MINS540- 0- 0- 0- 0
3999255INPATIENT CONSULTATION 110 MINS720- 0- 0- 0- 0
3999291CRITICAL CARE FIRST HOUR756756- 0- 0- 0 3999292CRITICAL CARE
ADDL 30 MINS378- 0- 0- 0- 0 3999304INITIAL NURSING FACILITY
CARE/DAY 25 MIN198- 0- 0- 0- 0 3999305INITIAL NURSING FACILITY
CARE/DAY 35 MIN288- 0- 0- 0- 0 3999306INITIAL NURSING FACILITY
CARE/DAY 45 MIN360- 0- 0- 0- 0 3999307SBSQ NRS FAC CARE/DAY E/M
STABLE 10 MINS108- 0- 0- 0- 0 3999308SBSQ NRS FAC CARE/DAY E/M
STABLE 15 MINS171- 0- 0- 0- 0 3999309SBSQ NRS FAC CARE/DAY E/M
STABLE 25 MINS234- 0- 0- 0- 0 3999310SBSQ NRS FAC CARE/DAY E/M
STABLE 35 MINS306- 0- 0- 0- 0 3999315NURSING FACILITY DISCHARGE 30
MIN252- 0- 0- 0- 0 3999316NURSING FACILITY DISCH MORE THEN 30
MIN288- 0- 0- 0- 0 3999354PROLONGED SERVICE OFFICE320- 0320320- 0
3999355PROLONGED SERVICE OFFICE160- 0160160- 0 3999356PROLONGED
SERVICE INPATIENT352352- 0- 0- 0 3999357PROLONGED SERVICE
INPATIENT176176- 0- 0- 0 3999460INTL HOSP NEWBORN352- 0- 0- 0- 0
3999462NEW BORN CARE SUBSEQ160- 0- 0- 0- 0 3999463SAME DAY NB
DISCHARGE408408- 0- 0- 0 4000000GUEST TRAY- 0- 0- 0- 0- 0
40000011500 CAL ADA PUREED- 0- 0- 0- 0- 0 4000002BLAND SURGICAL
SOFT- 0- 0- 0- 0- 0 4000003FOOD/BEVERAGE PREFERENCE- 0- 0- 0- 0- 0
4000004NUTRITIONAL CONSULT- 0- 0- 0- 0- 0 4000005SPECIAL
INSTRUCTIONS- 0- 0- 0- 0- 0 40000061500 CAL MECH SOFT (ADA)- 0- 0-
0- 0- 0 4000007TUBE FEEDING- 0- 0- 0- 0- 0 4000008NPO/HOLD- 0- 0-
0- 0- 0 4000009REGULAR- 0- 0- 0- 0- 0 4000010ADA 1500- 0- 0- 0- 0-
0 4000011BLAND/SURGICAL SOFT- 0- 0- 0- 0- 0 4000012FULL LIQUID- 0-
0- 0- 0- 0 4000013CLEAR LIQUID- 0- 0- 0- 0- 0 4000014REGULAR DIET
SOFT- 0- 0- 0- 0- 0 4000015REGULAR MECHANICAL- 0- 0- 0- 0- 0
40000161200 ADA PUREED- 0- 0- 0- 0- 0 40000171200 ADA SOFT- 0- 0-
0- 0- 0 40000181400 ADA- 0- 0- 0- 0- 0 40000191400 ADA CHOPPED- 0-
0- 0- 0- 0 40000201400 ADA MECHANICAL SOFT- 0- 0- 0- 0- 0
40000211400 ADA PUREED- 0- 0- 0- 0- 0 40000221400 ADA SOFT- 0- 0-
0- 0- 0 40000231500 ADA- 0- 0- 0- 0- 0 40000241500 ADA CHOPPED- 0-
0- 0- 0- 0 40000251500 ADA MECHANICAL SOFT- 0- 0- 0- 0- 0
40000261500 ADA PUREED- 0- 0- 0- 0- 0 40000271500 ADA SOFT- 0- 0-
0- 0- 0 40000281600 ADA- 0- 0- 0- 0- 0 40000291600 ADA CHOPPED- 0-
0- 0- 0- 0 40000301600 ADA MECHANICAL SOFT- 0- 0- 0- 0- 0
40000311600 ADA PUREED- 0- 0- 0- 0- 0 40000321600 ADA SOFT- 0- 0-
0- 0- 0 4000033ADA 1800- 0- 0- 0- 0- 0 40000341800 ADA CHOPPED- 0-
0- 0- 0- 0 40000351800 CAL MECH SOFT (ADA)- 0- 0- 0- 0- 0
40000361800 CAL PUREED (ADA)- 0- 0- 0- 0- 0 40000371500 CAL ADA -
2GM NA- 0- 0- 0- 0- 0 40000382000 ADA- 0- 0- 0- 0- 0 40000392000
ADA CHOPPED- 0- 0- 0- 0- 0 40000402000 ADA MECHANICAL SOFT- 0- 0-
0- 0- 0 40000412000 ADA PUREED- 0- 0- 0- 0- 0 40000422000 ADA SOFT-
0- 0- 0- 0- 0 40000432200 ADA- 0- 0- 0- 0- 0 40000442200 ADA
CHOPPED- 0- 0- 0- 0- 0 40000452200 ADA MECHANICAL SOFT- 0- 0- 0- 0-
0 40000462200 ADA PUREED- 0- 0- 0- 0- 0 40000472200 ADA SOFT- 0- 0-
0- 0- 0 40000482400 ADA- 0- 0- 0- 0- 0 40000492400 ADA CHOPPED- 0-
0- 0- 0- 0 40000502400 ADA MECHANICAL SOFT- 0- 0- 0- 0- 0
40000512400 ADA PUREED- 0- 0- 0- 0- 0 40000522400 ADA SOFT- 0- 0-
0- 0- 0 40000532600 ADA- 0- 0- 0- 0- 0 40000542600 ADA CHOPPED- 0-
0- 0- 0- 0 40000552600 ADA MECHANICAL SOFT- 0- 0- 0- 0- 0
40000562600 ADA PUREED- 0- 0- 0- 0- 0 40000572600 ADA SOFT- 0- 0-
0- 0- 0 4000058NO CONC SUGARS- 0- 0- 0- 0- 0 4000059NO CONCENTRATED
SUGARS CHOPPED- 0- 0- 0- 0- 0 4000060NO CONC SUGARS MECHANICAL- 0-
0- 0- 0- 0 4000061NO CONC SUGARS PUREED- 0- 0- 0- 0- 0 4000062NO
CONC SUGARS SOFT- 0- 0- 0- 0- 0 4000063FLUID RESTRICTED- 0- 0- 0-
0- 0 4000064FLUID RESTRICTED CHOPPED- 0- 0- 0- 0- 0 4000065FLUID
RESTRICTED MECHANICAL SOFT- 0- 0- 0- 0- 0 4000066FLUID RESTRICTED
PUREED- 0- 0- 0- 0- 0 4000067FLUID RESTRICTED SOFT- 0- 0- 0- 0- 0
4000068GALL BLADDER- 0- 0- 0- 0- 0 4000069GALL BLADDER CHOPPED- 0-
0- 0- 0- 0 4000070GALL BLADDER MECHANICAL SOFT- 0- 0- 0- 0- 0
4000071GALL BLADDER PUREED- 0- 0- 0- 0- 0 4000072GALL BLADDER SOFT-
0- 0- 0- 0- 0 4000073GLUTEN FREE- 0- 0- 0- 0- 0 4000074GLUTEN FREE
CHOPPED- 0- 0- 0- 0- 0 4000075BLAND LOW ACID- 0- 0- 0- 0- 0
4000076GLUTEN FREE PUREED- 0- 0- 0- 0- 0 4000077PEDIATRIC AGE
APPROPRIATE- 0- 0- 0- 0- 0 4000078CARDIAC CHOPPED- 0- 0- 0- 0- 0
4000079CARDIAC (2GM NA, LOW FAT,& CHOL)- 0- 0- 0- 0- 0
4000080CARDIAC (2GM NA, LOW FAT&CHOL)- 0- 0- 0- 0- 0
4000081CARDIAC PUREED (2GM NA, LOW FAT & CHOL)- 0- 0- 0- 0- 0
40000821500 CAL PUREED (ADA)- 0- 0- 0- 0- 0 4000083LACTOSE FREE- 0-
0- 0- 0- 0 4000084LACTOSE FREE CHOPPED- 0- 0- 0- 0- 0
4000085LACTOSE FREE MECHANICAL SOFT- 0- 0- 0- 0- 0 4000086LACTOSE
FREE PUREED- 0- 0- 0- 0- 0 4000087LACTOSE FREE SOFT- 0- 0- 0- 0- 0
4000088LOW FAT/CHOLESTEROL- 0- 0- 0- 0- 0 4000089LOW CHOLESTEROL
CHOPPED- 0- 0- 0- 0- 0 4000090LOW FAT/CHOLESTEROL MECHANICAL- 0- 0-
0- 0- 0 4000091LOW FAT/CHOLESTEROL PUREED- 0- 0- 0- 0- 0
4000092GLUTEN FREE MECHANICAL- 0- 0- 0- 0- 0 4000093ADA 1800 2GM
NA- 0- 0- 0- 0- 0 40000942GM NA (SODIUM)- 0- 0- 0- 0- 0 4000095LOW
FAT MECHANICAL SOFT- 0- 0- 0- 0- 0 4000096LOW FAT PUREED- 0- 0- 0-
0- 0 4000097HIGH PROTEIN DIET- 0- 0- 0- 0- 0 4000098LOW POTASSIUM-
0- 0- 0- 0- 0 4000099LOW POTASSIUM PUREED- 0- 0- 0- 0- 0 4000100LOW
POTASSIUM CHOPPED- 0- 0- 0- 0- 0 4000101LOW POTASSIUM MECHANICAL
SOFT- 0- 0- 0- 0- 0 4000102DYSPHAGIA DIET- 0- 0- 0- 0- 0 4000103NAS
(NO SALT ADDED)- 0- 0- 0- 0- 0 4000104HIGH PROTEIN GLUTEN FREE- 0-
0- 0- 0- 0 4000105NAS MECH SOFT (NO SALT ADDED)- 0- 0- 0- 0- 0
4000106NAS PUREED (NO SALT ADDED)- 0- 0- 0- 0- 0 4000107NAS SOFT
(NO SALT ADDED)- 0- 0- 0- 0- 0 4000108RENAL(80G PRO, 2GM NA, LOW
PHOS)- 0- 0- 0- 0- 0 4000109RENAL CHOPPED- 0- 0- 0- 0- 0
4000110RENAL MECHANICAL SOFT(80G PRO, 2GM NA, L- 0- 0- 0- 0- 0
4000111RENAL PUREED(80G PRO, 2GM NA, LOW PHOS)- 0- 0- 0- 0- 0
4000112RENAL SOFT(80G PRO, 2GM NA, LOW PHOS)- 0- 0- 0- 0- 0
4000113HIGH PROTEIN MECH- 0- 0- 0- 0- 0 4000114HS SNACK- 0- 0- 0-
0- 0 4000115STRICT LOW RESIDUE MECHANICAL- 0- 0- 0- 0- 0
4000116STRICT LOW RESIDUE PUREED- 0- 0- 0- 0- 0 4000117STRICT LOW
RESIDUE SOFT- 0- 0- 0- 0- 0 4000118REGULAR PUREED- 0- 0- 0- 0- 0
4000119LACTOSE FREE DIET- 0- 0- 0- 0- 0 4000120COUMADIN / VIT. K
DIET- 0- 0- 0- 0- 0 4052630REMOVE PROSTATE REGROWTH- 0- 0- 0- 0- 0
4200000CLINIC JUST LIKE- 0- 0- 0- 0- 0 4200105COLONOSCOPY
FLEXIBLE1,844- 0- 0909- 0 4200121COLONOSCOPY FLEXIBLE1,844- 0-
01,176- 0 4201360HHN105- 0- 0105- 0 4204104ARISTICORT 61-80 MG
INJ10- 0- 032- 0 4204155MEPERIDINE & PHENERGAN INJ10- 0- 09- 0
4204180DEPOPROVERA CONTRACEPTIVE 150 MG10- 0- 063- 0
4204182PHENERGAN 0-50 MG INJ10- 0- 09- 0 4204233LUPRON 7.5 MG2,250-
0- 02,250- 0 4204235INFED 1CC10- 0- 027- 0 4204250PULSE OX TEST13-
0- 0- 0- 0 4204267ZZZ TESTOSTERONE 500 MG10- 0- 030- 0
4204270ZOLADEX 3.6 MG INJ10- 0- 0646- 0 4204312MENINGITIS
VACCINATION10- 0- 092- 0 4204314TYPHOID IMMUNIZATION10- 0- 028- 0
4204315YELLOW FEVER VACCINATION10- 0- 072- 0 4204319MORPHINE 1-10
MG INJ10- 0- 011- 0 4204321SYNVISC HYLAN 6-F 2010- 0- 0321- 0
4204332MORPHINE 15 MG INJ10- 0- 020- 0 4204338EPOGEN 1000 UNITS10-
0- 022- 0 4204353TWINRIX HEP A & B ADULT VACC186- 0- 0186- 0
4205000CL-ACETYLCYSTEINE INH SOL 20% (10 ML)126- 0- 044- 0
4205001CL-AL HYDROX/MG HYDROX/SIMETH MYLANTA LI10- 0- 0- 0- 0
4205002CL-ALBUTEROL SULF NEB 0.083% (3 ML)- 0- 0- 0- 0- 0
4205003CL-AMMONIA NASAL INH 0.1510- 0- 0- 0- 0 4205004CL-APAP
CAPLET 500 MG10- 0- 0- 0- 0 4205005CL-APAP SOL 160/ 5 ML10- 0- 04-
0 4205006CL-APAP FEVER ALL SUPP 80 MG10- 0- 010- 0
4205007CL-ARIPIPRAZOLE ABILIFY TAB 10 MG51- 0- 0- 0- 0
4205008CL-ASCORBIC ACID VITAMIN C 500MG TAB10- 0- 0- 0- 0
4205009CL-ASPIRIN TAB 81 MG10- 0- 0- 0- 0 4205010CL-ASPIRIN EC TAB
325 MG10- 0- 0- 0- 0
4205011CL-ATR;HYO;PHENOBAR/SCOP/LIDOC/MAALOX27- 0- 014- 0
4205013CL-BACITRACIN;NEOMYCIN;POLYMYXIN B OINT10- 0- 0- 0- 0
4205014CL-BACITRACIN;POLYMYXIN B POLYSPORIN OIN10- 0- 0- 0- 0
4205015CL-BENZOCAINE HURRICAINE SPRAY AEROSOL48- 0- 0- 0- 0
4205016CL-BENZOIN TINCTURE SOL 59 ML32- 0- 013- 0
4205017CL-BISACODYL SUPP 10 MG10- 0- 0- 0- 0 4205018CL-BUPIVACAIN
0.25% INJ 2.5MG/ML (10ML)15- 0- 010- 0 4205019CL-BUPIVACAIN 0.5%
INJ 5MG/ML60- 0- 0- 0- 0 4205020CL-BUPIVACAINE MARCAINE 0.25% PF
0.002515- 0- 0- 0- 0 4205021CL-BUPIVACAINE MARCAINE 0.5% PF
0.00517- 0- 0- 0- 0 4205022CL-BUPIVACAINE/EPI 0.5% 10ML31- 0- 013-
0 4205023CL-CALCIUM CARBONATE 500MG TABLET9- 0- 0- 0- 0
4205024CL-CARBAMIDE PEROXIDE DEBROX OTIC 6.5%26- 0- 0- 0- 0
4205025CL-CEFTRIAXONE ROCEPHIN INJ 2 GM44- 0- 023- 0
4205026CL-CEFTRIAXONE ROCEPHIN INJ 250 MG16- 0- 012- 0
4205027CL-CEFTRIAXONE: ROCEPHIN INJ 1 GM33- 0- 013- 0
4205028CL-CEFTRIAXONE: ROCEPHIN INJ 500 MG25- 0- 012- 0
4205029CL-CHLORAL HYDRATE SYRUP 500 MG/5 ML10- 0- 0- 0- 0
4205030CL-CHLORPROMAZINE INJ 25 MG/ML (1 ML)53- 0- 025- 0
4205031CL-CLONIDINE TAB 0.1MG10- 0- 010- 0 4205032CL-COCAINE HCL
TOP SOL 4% (4 ML)129- 0- 045- 0 4205033CL-CYANOCOBALAMIN INJ
1000MCG/ML(1ML)10- 0- 0- 0- 0 4205034CL-CYCLOPENTOLATE OPTH SOL 2%
(2ML)82- 0- 042- 0 4205035CL-DARBEPOETIN ARANESP INJ
300MCG/0.6ML8,742- 0- 03,016- 0 4205036CL-DENOSUMAB 60MG/ML1,561-
0- 0- 0- 0 4205037CL-DERMABOND SKIN BOND- 0- 0- 0- 0- 0
4205038CL-DEXAMETHASONE DECADRON INJ 4MG/ML SD10- 0- 0- 0- 0
4205039CL-DEXAMETHASONE INJ 10MG / ML25- 0- 017- 0
4205040CL-DIGOXIN LANOXIN TAB 0.25 MG10- 0- 0- 0- 0
4205041CL-DIP;TET TOX;ACELL PERTUS;HEP B&POLIOV439- 0- 0105- 0
4205042CL-DIPHENHYDRAMINE BENADRYL INJ 50MG/ML10- 0- 0- 0- 0
4205043CL-DIPHENHYDRAMINE BENADRYL LIQ 12.5MG/510- 0- 0- 0- 0
4205044CL-DIPHENHYDRAMINE BENADRYL TAB 25 MG10- 0- 0- 0- 0
4205045CL-DIPT TET TOX (BOOSTRIX) A PERTUS ADUL157- 0- 053- 0
4205046CL-DIPT TET TOX (Tdap) A PERTUS ADULT- 0- 0- 0- 0- 0
4205047CL-DIPT/TET/PERTUS INFANRIX (DTaP)85- 0- 043- 0
4205048CL-DIPT;TET TOX TENIVAC VAC51- 0- 0- 0- 0 4205049CL-DIPT;TET
TOX;A PERTUS PEDIATRIC138- 0- 048- 0 4205050CL-EPINEPHRI NASAL
ADRENALIN CHL SOL 1MG130- 0- 046- 0 4205051CL-EPINEPHRINE HCL INJ
1MG/ML (1 ML)10- 0- 0- 0- 0 4205052CL-EPOETIN EPOGEN INJ
3000U/ML227- 0- 080- 0 4205053CL-EPOETIN EPOGEN INJ 4000 U/ML301-
0- 0105- 0 4205054CL-EPOETIN EPOGEN-S INJ 10,000 U/ML750- 0- 0260-
0 4205055CL-EPOETIN INJ 20,000 U/ML2,420- 0- 0647- 0 4205056CL-ERY
ETHYLSUC; SULFISOX ACET SUSP (1090- 0- 0- 0- 0 4205057CL-ESTRADIOL
DELESTROGEN INJ 40 MG/ML197- 0- 069- 0 4205058CL-ESTRADIOL
DEPO-ESTRADIOL INJ 5 MG/ML41- 0- 016- 0 4205059CL-FULVESTRANT
FASLODEX INJ 250MG/5ML1,873- 0- 0- 0- 0 4205060CL-GENTAMICIN
OINTMENT OPTH 0.3%48- 0- 028- 0 4205061CL-GENTIAN VIOLET SOL/TOP 1%
(30ML10- 0- 0- 0- 0 4205062CL-GLUCAGEN INJ 1 MG VIAL445- 0- 0155- 0
4205063CL-GOSERELIN ACET IMP 10.8MG- 0- 0- 02,403- 0
4205064CL-GOSERELIN IMPLANT 3.6MG1,602- 0- 0802- 0
4205065CL-GUAIFENESIN/CODEINE SYRUP100MG/10MG 510- 0- 0- 0- 0
4205066CL-HAEMOPHILUS B CONJUGATE VACCINE87- 0- 043- 0
4205067CL-HALOPERIDOL DECANOATE 50MG/ML INJ261- 0- 091- 0
4205068CL-HALOPERIDOL HALDOL INJ 5 MG/ML(1ML)64- 0- 023- 0
4205069CL-HEPATITIS A ADULT 1440 ELISA U/ML362- 0- 0126- 0
4205070CL-HEPATITIS A VAC PED/ADOL 720UNITS179- 0- 066- 0
4205071CL-HEPATITIS B ADULT ENGERIX-B VAC 20MCG327- 0- 0115- 0
4205072CL-HEPATITIS B PED/ADOLESCEN VAC10MCG/0.134- 0- 021- 0
4205073CL-HIB-IPV-DTAP VACCINE160- 0- 0- 0- 0 4205074CL-HUMAN
PAPILLOMAVIRUS GARDASIL INJ 0.5776- 0- 0270- 0
4205075CL-HYDROXYPROGESTERONE CAPROATE 250MG/ML1,392- 0- 0- 0- 0
4205076CL-HYDROXYZINE INJ 25 MG/ML (1 ML)10- 0- 0- 0- 0
4205077CL-HYLAN G-F 202,249- 0- 01,499- 0 4205078CL-IBUPROFEN TAB
800MG10- 0- 0- 0- 0 4205079CL-IMMUNE GLOBULIN (GAMASTAN) 2ML302- 0-
0202- 0 4205080CL-INFLUENZA 6-35 MONTHS VACCINE45- 0- 026- 0
4205081CL-INFLUENZA VIRUS VAC FLUZON INJ OVER 3119- 0- 026- 0
4205082CL-INSULIN REGULAR HUMULIN R INJ 100 U/M11- 0- 0- 0- 0
4205083CL-IPOL168- 0- 060- 0 4205084CL-IPRATROPIUM BROMIDE INH
0.5MG/2.5ML12- 0- 010- 0 4205085CL-IRON DEXTRAN COMPLEX INFED INJ
50MG/M192- 0- 081- 0 4205086CL-JE-VAX479- 0- 0350- 0
4205087CL-KETOROLAC INJ 60 MG / 2 ML13- 0- 010- 0
4205088CL-LEUPROLIDE ACE 30MG5,202- 0- 0- 0- 0 4205089CL-LEUPROLIDE
DEPOT 22.5 (3MONTH)3,850- 0- 0- 0- 0 4205090CL-LEUPROLIDE DEPOT
3.75MG1,145- 0- 0- 0- 0 4205091CL-LEUPROLIDE DEPOT 45MG
(6MONTH)7,779- 0- 0- 0- 0 4205092CL-LEUPROLIDE DEPOT 7.5MG1,622- 0-
0- 0- 0 4205093CL-LIDOCAINE 5 MG/ML 50ML VIAL14- 0- 0- 0- 0
4205094CL-LIDOCAINE HCL TOP SOL 4% (50 ML)13- 0- 014- 0
4205095CL-LIDOCAINE JELLY 2% 5ML43- 0- 016- 0 4205096CL-LIDOCAINE
ORAL VISCOUS 2% SOLUTION10- 0- 0- 0- 0 4205097CL-LIDOCAINE W/ EPI
INJ 20MG/ML22- 0- 0- 0- 0 4205098CL-LIDOCAINE XYLO INJ 10 MG/ML 20
ML20- 0- 014- 0 4205099CL-LIDOCAINE XYLO INJ 20 MG/ML (20 ML)15- 0-
014- 0 4205100CL-LORAZEPAM INJ 2 MG ML 1 ML17- 0- 010- 0
4205101CL-MAGNESIUM SULF INJ 500MG/ML17- 0- 012- 0
4205102CL-MEASLES MUMPS AND RUBELLA VAC 0.5ML289- 0- 0120- 0
4205103CL-MEDROXYPROGESTERONE INJ 150MG/ML242- 0- 095- 0
4205104CL-MENINGOCOCCAL (MENACTRA)566- 0- 0166- 0
4205105CL-MEPERIDINE DEMEROL INJ SYRINGE 100MG/11- 0- 012- 0
4205106CL-MEPERIDINE DEMEROL INJ SYRNGE 25MG/ML10- 0- 0- 0- 0
4205107CL-MEPERIDINE DEMEROL INJ SYRNGE 50MG/ML11- 0- 012- 0
4205108CL-METHYLPREDNISO SOLU-MEDROL INJ 125MG30- 0- 012- 0
4205109CL-METHYLPREDNISO SOLU-MEDROL INJ 40MG20- 0- 010- 0
4205110CL-METHYLPREDNISOL DEPO-MEDROL INJ 40MG/47- 0- 018- 0
4205111CL-METHYLPREDNISOL DEPO-MEDROL INJ 80MG81- 0- 029- 0
4205112CL-METOCLOPRAMIDE INJ 5 MG/ML 2 ML10- 0- 0- 0- 0
4205113CL-MIDAZOLAM INJ 1MG/1 ML (5 ML)14- 0- 010- 0
4205114CL-MIRENA1,707- 0- 0- 0- 0 4205115CL-MORPHINE SULFATE
10MG/ML (1ML)10- 0- 0- 0- 0 4205116CL-NEUPOGEN 300MCG/ML INJ939- 0-
0441- 0 4205117CL-NEXPLANON1,732- 0- 0- 0- 0 4205118CL-NIFEDIPINE
CAPS 10 MG10- 0- 0- 0- 0 4205119CL-NITROGLYCERIN SL TABS 0.4 MG10-
0- 0- 0- 0 4205120CL-OCTREOTIDE 100MCG/ML31- 0- 0- 0- 0
4205121CL-OFLOXACIN FLOXIN OTIC 0.3% (5 ML)149- 0- 0- 0- 0
4205122CL-ONDANSETRON 4MG/2ML24- 0- 012- 0 4205123CL-ONDANSETRON
ODT ZOFRAN TAB 8 MG136- 0- 069- 0 4205124CL-OXYMETAZOLINE NASAL
0.05% (15 ML)19- 0- 0- 0- 0 4205125CL-PALIVIZUMAB (RSV VACC)
50MG3,429- 0- 02,286- 0 4205126CL-PARAGARD IUD1,063- 0- 0- 0- 0
4205127CL-PEGFILGRASTIM INJ SYRINGE 6 MG/0.6 ML9,726- 0- 07,066- 0
4205128CL-PEN G BENZATH; PEN G PROCAI INJ 1.2201- 0- 0144- 0
4205129CL-PEN G BENZATHINE INJ 1,200,000MU253- 0- 088- 0
4205130CL-PHENOBARBITAL INJ 130 MG/ML (1 ML)24- 0- 011- 0
4205131CL-PHENYLEPHRINE OPTH SOL 2.5%(2ML)22- 0- 010- 0
4205132CL-PHYTONADIONE VIT K-NEONATAL 1 MG/0.5M46- 0- 0- 0- 0
4205133CL-PHYTONADIONE VITAMIN K INJ AMP 10MG/M57- 0- 021- 0
4205134CL-PNEUMOCOCCAL 7 VALENT PREVNAR VAC487- 0- 0169- 0
4205135CL-PNEUMOCOCCAL VAC 13 (PREVNAR)233- 0- 0241- 0
4205136CL-PNEUMOCOCCAL VAC 23 (PNEUMOVAX)192- 0- 086- 0
4205137CL-POLIDOCANOL (ASCLERA) 1%62- 0- 0- 0- 0
4205138CL-POLYMYXIN/BACITRAC OPTH OINT 3.5G39- 0- 033- 0
4205139CL-POTASSIUM EFFERVESCENT TABS 25 MEQ10- 0- 0- 0- 0
4205140CL-PROCHLOPERAZINE INJ 5 MG/ ML (2ML)34- 0- 010- 0
4205141CL-PROCHLOPERAZINE SUPP 25 MG19- 0- 010- 0
4205142CL-PROGESTERONE INJ 50 MG/ ML (10 ML)22- 0- 010- 0
4205143CL-PROMETHAZINE INJ 25 MG/ML (1 ML)11- 0- 0- 0- 0
4205144CL-PROMETHAZINE INJ 50 MG/ML (1 ML)14- 0- 012- 0
4205145CL-PROMETHAZINE SUPP 12.5MG22- 0- 010- 0
4205146CL-PROPARACAINE HCL OPTH SOL 0.5% (15ML)60- 0- 030- 0
4205147CL-RABIES IMMUNE GLOBULIN INJ 150 IU/ML866- 0- 0299- 0
4205148CL-RABIES VIRUS VAC 2.5 INT. UNITS/ML1,023- 0- 0353- 0
4205149CL-RH0(D) IMMUNE GLOBULIN RHOGAM INJ 300640- 0- 0223- 0
4205150CL-RISPERIDONE LONG ACTING INJ 25MG1,504- 0- 0520- 0
4205151CL-ROTATEQ VACCINE109- 0- 0109- 0 4205152CL-SILVER
NITRATE/POTASSIUM NITRATE APPL10- 0- 0- 0- 0 4205153CL-SILVER
SULFADIAZINE CRM 1% 25G28- 0- 0- 0- 0 4205154CL-SOD BICARBONATE INJ
8.4% (50ML) VIAL10- 0- 0- 0- 0 4205155CL-SOD CHL INJ 0.9% 20 ML
MPF10- 0- 0- 0- 0 4205156CL-SODIUM SULFATE/POTAS SULF/MAGN SULF148-
0- 0- 0- 0 4205157CL-STERILE DILUENT INJ 0.7ML4- 0- 0- 0- 0
4205158CL-STERILE WATER INJ 10ML10- 0- 0- 0- 0
4205159CL-SUMATRIPTAN IMITREX INJ 12MG/ML456- 0- 0160- 0
4205160CL-TERBUTALINE INJ 1MG/ML (1 ML)27- 0- 011- 0
4205161CL-TESTOSTERONE CYPIONATE INJ 100MG/ML31- 0- 013- 0
4205162CL-TESTOSTERONE CYPIONATE INJ 200MG/ML70- 0- 043- 0
4205163CL-TETANUS TOXOID INJ 0.5 ML134- 0- 047- 0
4205164CL-TETRACAINE OPTH SOL 5 MG/ML (15ML)25- 0- 011- 0
4205165CL-TETRACAINE OPTH 0.5 2ML39- 0- 015- 0 4205166CL-THIAMINE
INJ 100MG/ML 2ML65- 0- 024- 0 4205167CL-TRIAMCINOLONE OINT 0.1%17-
0- 0- 0- 0 4205168CL-TRIAMCINOLONE ACETONIDE INJ 10MG/ML14- 0- 010-
0 4205169CL-TRIAMCINOLONE ACETONIDE INJ 40MG/ML46- 0- 020- 0
4205170CL-TRIAMCINOLONE KENALOG SPRAY354- 0- 0- 0- 0
4205171CL-TUBERCULIN PURIFIED TESTS INJ 5 TU/0.35- 0- 0- 0- 0
4205172CL-TWINRIX VACCINE-ADULT USE257- 0- 0171- 0
4205173CL-TYPHOID VACCINE97- 0- 0- 0- 0 4205174CL-VARICELLA VACCINE
LIVE481- 0- 0167- 0 4205175CL-VITAMIN A;VITAMIN D OINT 5 G10- 0- 0-
0- 0 4205176CL-YELLOW FEVER VACCINE151- 0- 0- 0- 0 4205177CL-ZOSTER
VAC LIVE ZOSTAVAX INJ998- 0- 0345- 0 4205178CL-BCG TICE- 0281-
0281- 0 4205179CL-METRONIDAZOLE ORAL TABLET 250MG10- 0- 08- 0
4205180CL-AZITHROMYCIN ORAL TABLET 250MG19- 0- 08- 0
4205181CL-CIMZIA SUBQ SOLUTION 200MG/1ML2,938- 0- 0- 0- 0
4209290PEAK FLOW METER88- 0- 088- 0 4210021FINE NEEDLE ASPIRATION-
0- 0- 0250- 0 4210022FINE NEEDLE ASP W IMAGI1,032- 0- 01,032- 0
4210040ACNE SURGERY195- 0- 0127- 0 4210060I & D ABSCESS
SIMPLE518- 0- 0224- 0 4210061I & D COMPLICATED OR MULTIPLE946-
0- 0376- 0 4210080I & D PILONIDAL CYST414- 0- 0181- 0
4210081INCISION DRAINAGE PILONIDAL CYST COMPLIC- 0- 0- 02,904- 0
4210120FB REMOVAL SQ SIMPLE1,053- 0- 0302- 0 4210121I & R
FOREIGN BODY- 0- 0- 0536- 0 4210140I & D OF HEMATOMA SIMPLE- 0-
0- 0181- 0 4210160ASPIRATION OF HEMATOMA400- 0- 0143- 0
4210180I&D PILONIDAL CYST COMP3,374- 0- 03,374- 0
4211000DEBRIDE EXTENS ECZE1,564- 0- 0143- 0 4211010DEBRIDE REM FB
OPEN1,105- 0- 01,105- 0 4211012DBRDMNT FRGN MTRL OPEN1,241- 0-
01,781- 0 4211040DEBRIDEMENTSKINPART T420- 0- 0181- 0 4211041DEBRID
SKIN FULL THICKN679- 0- 0270- 0 4211042DEBRIDE SKIN & SUBQ
TISSUE1,665- 0- 0393- 0 4211043DEBRIDE SKIN & SUBC722- 0- 0722-
0 4211044DEBRIDE SUBCU TISSUEMU2,278- 0- 0927- 0 4211055PARE CUT
CORN CALLUS200- 0- 090- 0 4211056PARE CUT CRN CALLUS 2-4215- 0-
0127- 0 4211057PARE CUT CORN LESIONS RESP CANCEL/CHANGE/DC
ORDERRESPIRATORY ORDEREKG ORDER
